Relieve Depression in Patients with Chronic Pain with Mindfulness-Based Cognitive Therapy (MBCT)

October 14, 2018 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“By developing a routine meditation practice, clients can use the technique whenever they start to feel overwhelmed by negative emotions. When sadness occurs and starts to bring up the usual negative associations that trigger relapse of depression, the client is equipped with tools that will help them replace negative thought patterns with positive.” – Psychology Today

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain in adults.

Chronic pain is often accompanied with depression. The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT). MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. It is not known, however if MBCT is also effective for the depression accompanying chronic pain.

In today’s Research News article “A Randomized Controlled Pilot Study on Mindfulness-Based Cognitive Therapy for Unipolar Depression in Patients with Chronic Pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020018/ ), De Jong and colleagues recruited adult patients with chronic pain and who were also clinically depressed. They were randomly assigned to either receive an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT) or to a treatment as usual wait list control. The MBCT group met once a week for 2 hours in groups of 7 and also engaged in daily home practice. They were measured before and after training for depression, pain, quality of life, anxiety, and perceptions of improvement.

They found that in comparison to baseline and the wait list control group that the participants who received MBCT had a significant decrease in depression but not pain. Hence, MBCT was an effective treatment for depression for patients with chronic pain. It did so by not affecting the levels of pain experienced. So, the effectiveness of MBCT was due to influencing depression directly independent of pain. It should be noted that there was not an active control condition and the sample sizes were small. So, these results need to be replicated in a larger randomized controlled clinical trial with an active control. Regardless, the results are encouraging and extend the types of depressed patients helped by MBCT.

So, relieve depression in patients with chronic pain with Mindfulness-Based Cognitive Therapy (MBCT).

“Most importantly, I seemed to be developing a whole new relationship with my thoughts. It wasn’t that they’d really changed; they were still the same old wolf- and fire- and death-fearing thoughts, but I could see that they were simply that: thoughts. I did not have to judge them, act on them or indeed do anything very much about them.“ – Julie Myerson

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

De Jong, M., Peeters, F., Gard, T., Ashih, H., Doorley, J., Walker, R., … Mischoulon, D. (2018). A Randomized Controlled Pilot Study on Mindfulness-Based Cognitive Therapy for Unipolar Depression in Patients with Chronic Pain. The Journal of Clinical Psychiatry, 79(1), 15m10160. http://doi.org/10.4088/JCP.15m10160

Abstract

Objective

Chronic Pain (CP) is a disabling illness, often comorbid with depression. We performed a randomized controlled pilot study on mindfulness-based cognitive therapy (MBCT) targeting depression in a CP population.

Methods

Participants with CP lasting ≥ 3 months, DSM-IV Major Depressive Disorder (MDD), Dysthymic Disorder, or Depressive disorder NOS, and a Quick Inventory of Depression scale (QIDS-C16) score ≥ 6 were randomized to MBCT (n = 26) or waitlist (n = 14). We adapted the original MBCT intervention for depression relapse prevention by modifying the psychoeducation and Cognitive Behavioral Therapy (CBT) elements to an actively depressed chronic pain population. We analyzed an intent-to treat (ITT) and a per protocol sample; the per protocol sample included participants in the MBCT group who completed at least 4 out of 8 sessions. The change in the QIDS-C16 and Hamilton Rating Sale for Depression (HRSD17) were the primary outcome measures. Pain, quality of life and anxiety were secondary outcome measures. Data collection took place between January 2012 and July 2013.

Results

Nineteen (73%) participants completed the MBCT program. No significant adverse events were reported in either treatment group. ITT analysis (n=40) revealed no significant differences. Repeated measures ANOVAs for the per protocol sample (n=33) revealed a significant treatment × time interaction (F (1, 31) = 4.67, p = 0.039, η2p = 0.13) for the QIDS-C16, driven by a significant decrease in the MBCT group (t (18) = 5.15, p < 0.001, d = 1.6), but not in the control group (t (13) = 2.01, p = 0.066). The HRSD17 scores did not differ significantly between groups. The study ended before the projected sample size was obtained, which might have prevented effect detection in some outcome measures.

Conclusions

MBCT shows potential as a treatment for depression in individuals with CP, but larger controlled trials are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020018/

Relieve Depression with Mindfulness-Based Cognitive Therapy (MBCT)

October 5, 2018 psyjdc Leave a comment

Relieve Depression with Mindfulness-Based Cognitive Therapy (MBCT)

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. 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).

The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT). MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs.

In today’s Research News article “Mindfulness-based cognitive therapy in patients with depression: current perspectives.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018485/ ), MacKenzie and colleagues review the published research literature on the application of Mindfulness-Based Cognitive Therapy (MBCT) to the treatment of depression. They find that the published research makes a very strong case that MBCT is a safe and effective treatment for depression, reducing depression when present and preventing relapse when in remission. The literature also finds that MBCT appears to act on depression by heightening mindfulness, increasing self-compassion and positive emotions and by reducing repetitive negative thoughts (rumination) and cognitive and emotional reactivity.

MBCT, however, classically requires a certified trained therapist. This produces costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules. As a result, on-line mindfulness training programs and workbook programs have been developed. These have tremendous advantages in decreasing costs and making training schedules much more flexible. MacKenzie and colleagues report that the research demonstrates that MBCT, delivered either over the web or via study-at-home workbooks is also a safe and effective treatment for depression.

The review suggests that Mindfulness-Based Cognitive Therapy (MBCT) has a wide variety of positive psychological effects on the participant that work to counter and prevent depression and that MBCT is effective delivered either by a trained therapist or over the web or via study-at-home workbooks.

So, relieve depression with Mindfulness-Based Cognitive Therapy (MBCT).

“MBCT therapists teach clients how to break away from negative thought patterns that can cause a downward spiral into a depressed state so they will be able to fight off depression before it takes hold.” – Psychology Today

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

MacKenzie, M. B., Abbott, K. A., & Kocovski, N. L. (2018). Mindfulness-based cognitive therapy in patients with depression: current perspectives. Neuropsychiatric Disease and Treatment, 14, 1599–1605. http://doi.org/10.2147/NDT.S160761

Abstract

Mindfulness-based cognitive therapy (MBCT) was developed to prevent relapse in individuals with depressive disorders. This widely used intervention has garnered considerable attention and a comprehensive review of current trends is warranted. As such, this review provides an overview of efficacy, mechanisms of action, and concludes with a discussion of dissemination. Results provided strong support for the efficacy of MBCT despite some methodological shortcomings in the reviewed literature. With respect to mechanisms of action, specific elements, such as mindfulness, repetitive negative thinking, self-compassion and affect, and cognitive reactivity have emerged as important mechanisms of change. Finally, despite a lack of widespread MBCT availability outside urban areas, research has shown that self-help variations are promising. Combined with findings that teacher competence may not be a significant predictor of treatment outcome, there are important implications for dissemination. Taken together, this review shows that while MBCT is an effective treatment for depression, continued research in the areas of efficacy, mechanisms of action, and dissemination are recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018485/

Improve Psychological Health with Mindfulness

October 1, 2018 psyjdc Leave a comment

Improve Psychological Health with Mindfulness

By John M. de Castro, Ph.D.

“Mindfulness exercises are ways of paying attention to the present moment, using techniques like meditation, breathing, and yoga. Training helps people to become more aware of their thoughts, feelings, and body sensations so that instead of being overwhelmed by them, they are better able to manage them. Practising mindfulness can give more insight into emotions, boost attention and concentration, and improve relationships.” – Mental Health Foundation

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. The vast majority of the mindfulness training techniques, however, 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 busy schedules and at locations that may not be convenient. As an alternative, online mindfulness training programs have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations.

One difficulty with understanding the effects of mindfulness training is that they often contain multiple components such as training on the ideas of mindfulness, practicing mindfulness in everyday activities, meditation, chanting, body scanning, yoga, etc. It cannot be determined then what component or combination of components are responsible for the effects. It would be helpful to compare one form of training with the same training minus single components to begin to isolate what components are necessary and sufficient for the benefits.

In today’s Research News article “A Randomised Controlled Trial of a Brief Online Mindfulness-Based Intervention in a Non-clinical Population: Replication and Extension.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6061247/ ), Cavanagh and colleagues compared a 2-week online mindfulness training containing meditation with the same training without meditation. They recruited university students and staff to participate in a “Learning Mindfulness online” course and randomly assigned them to receive either mindfulness training, mindfulness training without meditation, or a wait-list control condition.

The mindfulness training consisted of a 5-minute mindfulness video and a 2000-word teaching on mindfulness that recommended performing one activity per week mindfully. The training also had a daily guided walking exercise. When meditation was included it consisted of instructions on meditation and a daily 10-minute guided meditation. The participants were measured before and after training for mindfulness, perceived stress, anxiety, depression, perseverative thinking, and a daily questionnaire on the use of training components.

They found that in comparison to baseline and the wait-list control, both mindfulness training groups had significantly higher levels of mindfulness and significantly lower levels of perceived stress, anxiety, depression, and perseverative thinking. They also found that perseverative thinking mediated the effects of mindfulness on perceived stress, anxiety, and depression. That is mindfulness was associated with decreased perseverative thinking (worry, rumination) which was, in turn, associated with lower perceived stress, anxiety, and depression.

The primary findings that mindfulness training decreases perseverative thinking, perceived stress, anxiety, and depression and that rumination (perseverative thinking is an important mediator http://contemplative-studies.org/wp/index.php/category/research-news/anxiety/of the effects, are not new as have been documented repeatedly elsewhere. What is new is that a relatively brief, online, training is sufficient to produce these benefits. The fact that it could be taught exclusively online is important and suggests that mindfulness training can be implemented broadly, at low cost, and great convenience.

It was surprising that the inclusion of meditation in the mindfulness training did not add any extra benefits. This may suggest that training on the application of mindfulness to day to day living is the most important component of mindfulness training for producing improvements in the psychological state of otherwise healthy individuals. This suggests that it is using mindfulness in ongoing day to day activities is very important for the training to be effective.

So, improve psychological health with mindfulness.

“Their analysis indicated that one skill—the ability to consciously focus on moment-to-moment experiences—fully predicted the benefits of mindfulness for work-related maladies.” – Adam Hoffman

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

Cavanagh, K., Churchard, A., O’Hanlon, P., Mundy, T., Votolato, P., Jones, F., … Strauss, C. (2018). A Randomised Controlled Trial of a Brief Online Mindfulness-Based Intervention in a Non-clinical Population: Replication and Extension. Mindfulness, 9(4), 1191–1205. http://doi.org/10.1007/s12671-017-0856-1

Abstract

Building on previous research, this study compared the effects of two brief, online mindfulness-based interventions (MBIs; with and without formal meditation practice) and a no intervention control group in a non-clinical sample. One hundred and fifty-five university staff and students were randomly allocated to a 2-week, self-guided, online MBI with or without mindfulness meditation practice, or a wait list control. Measures of mindfulness, perceived stress, perseverative thinking and anxiety/depression symptoms within were administered before and after the intervention period. Intention to treat analysis identified significant differences between groups on change over time for all measured outcomes. Participation in the MBIs was associated with significant improvements in all measured domains (all ps < 0.05), with effect sizes in the small to medium range (0.25 to 0.37, 95% CIs 0.11 to 0.56). No significant changes on these measures were found for the control group. Change in perseverative thinking was found to mediate the relationship between condition and improvement on perceived stress and anxiety/depression symptom outcomes. Contrary to our hypotheses, no differences between the intervention conditions were found. Limitations of the study included reliance on self-report data, a relatively high attrition rate and absence of a longer-term follow-up. This study provides evidence in support of the feasibility and effectiveness of brief, self-guided MBIs in a non-clinical population and suggests that reduced perseverative thinking may be a mechanism of change. Our findings provide preliminary evidence for the effectiveness of a mindfulness psychoeducation condition, without an invitation to formal mindfulness meditation practice. Further research is needed to confirm and better understand these results and to test the potential of such interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6061247/

Improve Depression with Yoga

September 26, 2018 psyjdc Leave a comment

Improve Depression 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. 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 Health

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 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. Another effective alternative treatment is exercise. But it is difficult to get depressed people, who lack energy, to engage in regular exercise. Yoga is a contemplative practice that is both a mindfulness practice and an exercise. It has been shown to be effective in the treatment of depression and even yogic breathing alone has been found to be effective. So, the combination of yoga practice with breathing exercises should be particularly effective.

In today’s Research News article “The Efficacy of Yoga as a Form of Treatment for Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871291/ ), Bridges and colleagues review and summarize the 23 published research studies investigating the effectiveness of yoga practice for the relief of depression in adults. They found that yoga practice was effective in reducing depression in a wide variety of patients with a diagnosis of depression, including pregnant women, patients with lower back pain, cancer patients, patients with atrial fibrillation, persons with poststroke hemiparesis, and addicts.

Hence, there is accumulating a relatively large volume of scientific evidence that practicing yoga is an effective treatment for depression in a wide variety of cases. Yoga is a complex practice that can include postures, breathing practices, meditation, and chanting. The review does not suggest what components or combination of components are necessary and sufficient to reduce depression. Future research should be directed at isolating the effective components.

So, improve depression with yoga.

“Evidence keeps stacking up that yoga is a boon for both physical and mental health conditions. Now, a small new study from Boston University finds that taking yoga classes twice a week may help ease depression, thanks in part to deep breathing.” – Amanda McMillan

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

Bridges, L., & Sharma, M. (2017). The Efficacy of Yoga as a Form of Treatment for Depression. Journal of Evidence-Based Complementary & Alternative Medicine, 22(4), 1017–1028. http://doi.org/10.1177/2156587217715927

Abstract

The purpose of this article was to systematically review yoga interventions aimed at improving depressive symptoms. A total of 23 interventions published between 2011 and May 2016 were evaluated in this review. Three study designs were used: randomized control trials, quasi-experimental, and pretest/posttest, with majority being randomized control trials. Most of the studies were in the United States. Various yoga schools were used, with the most common being Hatha yoga. The number of participants participating in the studies ranged from 14 to 136, implying that most studies had a small sample. The duration of the intervention period varied greatly, with the majority being 6 weeks or longer. Limitations of the interventions involved the small sample sizes used by the majority of the studies, most studies examining the short-term effect of yoga for depression, and the nonutilization of behavioral theories. Despite the limitations, it can be concluded that the yoga interventions were effective in reducing depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871291/

Improve Depression in Overweight Adolescent Girls with Mindfulness

August 24, 2018 psyjdc Leave a comment

Improve Depression in Overweight Adolescent Girls with Mindfulness

By John M. de Castro, Ph.D.

“By practicing meditation, you’re able to gently develop a capacity to witness pain as it happens inside you without letting the stories your mind tells you cause you to act self-destructively. Meditation teaches us to wake up from the habits of our mind so we have clear, conscious choice in our actions. By practicing sitting still in silence—especially when I didn’t want to, when I didn’t ‘have time,’ or when it was wildly uncomfortable—and developing compassion for whatever showed up inside me, all the self-judgment and self-deprecation, my neuropathways were rewired.” – Michael Hebb

Adolescence is a transitional period marked by rapid physical, behavioral, emotional, and cognitive developmental changes. Up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Anxiety and depression during this stage can lead to impaired academic, social, and family functioning, and have long-term adverse outcomes.

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. Although this has been called adult-onset diabetes it is increasingly being diagnosed in children and adolescents. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world.

Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia.

It is clear that methods need to be found to reduce the likelihood of the development of Type II diabetes and depression in adolescents. One promising avenue is mindfulness. It has been shown to be effective in treating Type II diabetes. In today’s Research News article “Pilot Randomized Controlled Trial of a Mindfulness-Based Group Intervention in Adolescent Girls at Risk for Type 2 Diabetes with Depressive Symptoms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705100/ ), Shomaker and colleagues recruited overweight and obese adolescent girls (aged 12-17 years) with a family history of Type II Diabetes and who also had symptoms of depression and randomly assigned them to receive either a 6-week mindfulness-based or 6-week cognitive-behavioral program.

Both treatment programs met once a week for 1 hour and there was 10 minutes of homework daily. The mindfulness program occurred in groups and included breath awareness, body scanning, mindful eating, sitting meditation, loving kindness practice, and yoga. The cognitive-behavioral program also occurred in groups and included psycho-education, cognitive restructuring, pleasant activities, self-reinforcement, and coping skills. They were measured before and after treatment and 6 months later for mindfulness, depression, anxiety, perceived stress, insulin resistance, and body composition.

They found that after treatment that both groups had significant decreases in depression, anxiety, and perceived stress that persisted to the 6-month follow-up. The decrease in depression, however, was significantly greater in the mindfulness group. After treatment, the groups also had significant decreases in insulin resistance and fasting insulin levels, but the improvements were significantly greater in the mindfulness group. It is interesting that the programs affected insulin resistance and levels as they did not include dieting or exercise components. It should be noted, however, that these improvements did not persist at the 6-month follow-up while the psychological effects did.

These results are encouraging and suggest that both mindfulness-based and cognitive-behavioral programs are acceptable, safe, and effective for the psychological and physical states of adolescent girls who are overweight or obese, are mildly or moderately depressed and who are at-risk for Type II Diabetes. Importantly, the results show that mindfulness training is superior to cognitive-based programs in relieving symptoms. Treating these girls in adolescence may help to prevent or delay the onset of Type II Diabetes and improve the quality of life in this vulnerable population. This could go a long way toward reducing health care costs and preventing and relieving their suffering.

So, improve depression in overweight adolescent girls with mindfulness.

“In the last few years mindfulness has emerged as a way of treating children and adolescents with conditions ranging from ADHD to anxiety, autism spectrum disorders, depression and stress. And the benefits are proving to be tremendous.” – Julianne Garey

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Shomaker, L. B., Bruggink, S., Pivarunas, B., Skoranski, A., Foss, J., Chaffin, E., … Bell, C. (2017). Pilot Randomized Controlled Trial of a Mindfulness-Based Group Intervention in Adolescent Girls at Risk for Type 2 Diabetes with Depressive Symptoms. Complementary Therapies in Medicine, 32, 66–74. http://doi.org/10.1016/j.ctim.2017.04.003

Highlights

A mindfulness-based group was feasible and acceptable to adolescent girls at-risk for type 2 diabetes with depressive symptoms
Adolescents in the mindfulness-based group had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral group at post-treatment and six-months
Adolescents in the mindfulness-based group had greater decreases in insulin resistance and fasting insulin at post-treatment than adolescents in the cognitive-behavioral group

Abstract

Objective

(1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance.

Design and setting

Parallel-group, randomized controlled pilot trial conducted at a university.

Participants

Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16).

Interventions

Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation.

Main outcome measures

Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition.

Results

Most adolescents attended ≥80% sessions (mindfulness:92% versus cognitive-behavioral:87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps<.05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps<.05).

Conclusions

A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705100/

Measure Mindfulness Better in Depressed Patients with Changes in the EEG

August 20, 2018 psyjdc Leave a comment

Measure Mindfulness Better in Depressed Patients with Changes in the EEG

By John M. de Castro, Ph.D.

“as the popularity of mindfulness grows, brain imaging techniques are revealing that this ancient practice can profoundly change the way different regions of the brain communicate with each other – and therefore how we think – permanently.” – Tom Ireland

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 problem with understanding mindfulness effects is that there are, a wide variety of methods of measuring mindfulness. These methods primarily involve self-reports on paper and pencil scales. Unfortunately, these different measures differ conceptually and frequently produce divergent results.

Mindfulness training produces changes in the brain’s electrical activity. This can be measured by recording the electroencephalogram (EEG). The brain produces rhythmic electrical activity that can be recorded from the scalp. It is usually separated into frequency bands. One method to indirectly observe information processing in the brain is to measure the changes in the electrical activity that occur in response to specific stimuli. These are called event-related potentials or ERPs. The signal following a stimulus changes over time. The fluctuations of the signal after specific periods of time are thought to measure different aspects of the nervous system’s processing of the stimulus. Perhaps change in the ERPs resulting from mindfulness training may be a good measure of the increased mindfulness produced by the training and a strong predictor of symptom improvements.

In today’s Research News article “Measuring Mindfulness: A Psychophysiological Approach.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031749/ ), Bostanov and colleagues recruited adult patients with recurrent depression in remission and randomly assigned them to receive 8 weekly, 2 hour group sessions of either Mindfulness-Based Cognitive Therapy (MBCT) or group Cognitive Therapy (CT). They were also assigned 45 minutes of daily homework. MBCT begins with breath meditation and bodily sensation and progresses into learning to perceive thoughts and emotions as objects of mindful attention and as mental events and not as absolute truth, self or reality. CT contained all of the cognitive therapy components as MBCT but excluded mindfulness training.

The participants were measured before and after training for mindfulness, depression, positive and negative emotions, decentering, and curiosity. They also underwent recording from the scalp of electrical brain activity in response to a stimulus (event-related brain potentials, ERPs). With the participants instructed to perform breath meditation, they were periodically presented with a brief noise. The changes in the EEG in response to the noise were recorded and used to calculate the grand average event-related brain potentials.

They found that both the MBCT and CT groups had significant reductions in depression, rumination, and distraction and increases in mindfulness following the 8-week intervention period and one year later. Importantly, they found that the greater the change in the grand average event-related brain potentials resulting from treatment, the greater the reduction in depression symptoms and the greater the increase in mindfulness. These relationships were statistically strong. At the same time changes in the paper and pencil mindfulness measures were not significantly related to the improvements in depression.

These results suggest that changes in the brain are produced by mindfulness training and that these are reflected by changes in the electrical activity of the brain in response to sounds. The results further suggest that these brain activity changes are a better measure of the effectiveness of the mindfulness training than the traditional self-report measures. It was suggested that in the future these event related potential changes be used as the primary assessment instrument for mindfulness and the impact of mindfulness training on the individual.

So, measure mindfulness better in depressed patients with Changes in the EEG.

“Although meditation research is still in its infancy, a number of studies have investigated changes in brain activation at rest and during specific tasks that are associated with the practice of, or that follow, training in mindfulness meditation. There is emerging evidence that mindfulness meditation might cause neuroplastic changes in the structure and function of brain regions involved in regulation of attention, emotion and self-awareness.” – Sarah McKay

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

Bostanov, V., Ohlrogge, L., Britz, R., Hautzinger, M., & Kotchoubey, B. (2018). Measuring Mindfulness: A Psychophysiological Approach. Frontiers in Human Neuroscience, 12, 249. http://doi.org/10.3389/fnhum.2018.00249

Abstract

Mindfulness-based interventions have proved effective in reducing various clinical symptoms and in improving general mental health and well-being. The investigation of the mechanisms of therapeutic change needs methods for assessment of mindfulness. Existing self-report measures have, however, been strongly criticized on various grounds, including distortion of the original concept, response bias, and other. We propose a psychophysiological method for the assessment of the mindfulness learned through time-limited mindfulness-based therapy by people who undergo meditation training for the first time. We use the individual pre-post-therapy changes (dERPi) in the event-related brain potentials (ERPs) recorded in a passive meditation task as a measure of increased mindfulness. dERPi is computed through multivariate assessment of individual participant’s ERPs. We tested the proposed method in a group of about 70 recurrently depressed participants, randomly assigned in 1.7:1 ratio to mindfulness-based cognitive therapy (MBCT) or cognitive therapy (CT). The therapy outcome was measured by the long-term change (dDS) relative to baseline in the depression symptoms (DS) assessed weekly, for 60 weeks, by an online self-report questionnaire. We found a strong, highly significant, negative correlation (r = −0.55) between dERPi (mean = 0.4) and dDS (mean = −0.7) in the MBCT group. Compared to this result, the relationship between dDS and the other (self-report) measures of mindfulness we used was substantially weaker and not significant. So was also the relationship between dERPi and dDS in the CT group. The interpretation of dERPi as a measure of increased mindfulness was further supported by positive correlations between dERPi and the other measures of mindfulness. In this study, we also replicated a previous result, namely, the increase (dLCNV) of the late contingent negative variation (LCNV) of the ERP in the MBCT group, but not in the control group (in this case, CT). We interpreted dLCNV as a measure of increased meditative concentration. The relationship between dLCNV and dDS was, however, very week, which suggests that concentration might be relatively unimportant for the therapeutic effect of mindfulness. The proposed psychophysiological method could become an important component of a “mindfulness test battery” together with self-report questionnaires and other newly developed instruments.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031749/

Reduce Anxiety and Depression with Mindfulness

August 15, 2018 psyjdc Leave a comment

Reduce Anxiety and Depression with Mindfulness

By John M. de Castro, Ph.D.

“If you have unproductive worries, you can train yourself to experience those thoughts completely differently. “You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge.

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. This may indicate that treating the cognitive processes that underlie the anxiety may be an effective treatment. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Depression can be difficult to treat. Fortunately, Mindfulness training is also effective for treating depression.

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is based upon Cognitive Behavioral Therapy (CBT) and has also been shown to relieve anxiety and to be effective for depression. 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. Additionally, ACT helps people strengthen aspects of cognition such as in committing to valued living. 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 “Effectiveness of Acceptance and Commitment Therapy on Anxiety and Depression of Razi Psychiatric Center Staff.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839459/ ), Heydari and colleagues recruited adult volunteers with moderate symptoms of burnout and randomly assigned them to either receiving a program of Acceptance and Commitment Therapy (ACT) or to a no-treatment control condition. The ACT program was delivered over 8 weeks in once a week, 90-minute sessions. The participants were measured before and after training and 2 months later for anxiety and depression.

They found that after treatment and 2 months later the group that received Acceptance and Commitment Therapy (ACT) had large and significant decreases in both anxiety (35% reduction) and depression (20% reduction) while there were no significant changes in the no-treatment control participants. It is interesting that the participants were suffering from moderate burnout in their jobs. This indicates that ACT may be effective in treating career burnout.

It is important to note that these effects were still present 2 months after the completion of the therapy program. They thus appear to have lasting beneficial effects. It should be noted that since the there was no treatment in the control condition that a placebo effect may still be present and may potentially account for at least some of the improvements. Nevertheless the results are in line with previous studies that demonstrate that mindfulness training is effective in relieving anxiety and depression.

So, Reduce Anxiety and Depression with Mindfulness

“Anxiety softens when we can create a space between ourselves and what we’re experiencing. . .

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.” – Mindful

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

Heydari, M., Masafi, S., Jafari, M., Saadat, S. H., & Shahyad, S. (2018). Effectiveness of Acceptance and Commitment Therapy on Anxiety and Depression of Razi Psychiatric Center Staff. Open Access Macedonian Journal of Medical Sciences, 6(2), 410–415. http://doi.org/10.3889/oamjms.2018.064

Abstract

AIM:

Considering the key role of human resources as the main operator of organisations, the present research aimed to determine the effectiveness of acceptance and commitment therapy for anxiety and depression of Razi Psychiatric Center staff.

MATERIALS AND METHODS:

This research follows a quasi-experimental type with pre-test, post-test plans, and control group. Accordingly, 30 people were selected through volunteered sampling among Razi Psychiatric Center staff. Then, they were randomly placed into two groups of 15 (experimental and control) and evaluated using research tools. Research tools consisted of Beck Anxiety and Depression Inventories whose reliability and validity have been confirmed in several studies. Research data were analysed using the analysis of covariance (ANCOVA).

Results:

The statistical analysis confirmed the difference in the components of anxiety and depression in the experimental group, which had received acceptance and commitment therapy compared to the group that had not received any therapy in this regard (control group) (p < 0.05).

CONCLUSION:

Acceptance and commitment therapy reduces anxiety and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839459/

Relieve Depression with Mindfulness-Based Stress Reduction (MBSR) Training

July 27, 2018 psyjdc Leave a comment

Relieve Depression with Mindfulness-Based Stress Reduction (MBSR) Training

By John M. de Castro, Ph.D.

“Still, there are a handful of key areas — including depression, chronic pain, and anxiety — in which well-designed, well-run studies have shown benefits for patients engaging in a mindfulness meditation program, with effects similar to other existing treatments.” – Alvin Powell

In today’s Research News article “Effects of Mindfulness-Based Stress Reduction on Depression in Adolescents and Young Adults: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01034/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_686352_69_Psycho_20180626_arts_A ), Chi and colleagues review, summarize, and perform a meta-analysis of published randomize controlled trials (RCTs) of the application of a Mindfulness-Based Stress Reduction (MBSR) program for the treatment of depression in adolescents and young adults. They discovered 18 published studies including a total of 2042 patients from 18 to 25 years of age.

They found that the published studies found that Mindfulness-Based Stress Reduction (MBSR) treatment effectively reduced depression in these patients with a moderate effect size. The type of control condition made a difference as active control groups as opposed to no-treatment control groups also produced significant reductions in depression. So, in comparison to active control groups MBSR had a smaller effect size. This suggests that placebo effects (subject expectancy effects) were responsible for some of the improvements and overall MBSR had an even greater impact on depression.

Hence, the published research literature supports the conclusion that MBSR is a safe and moderately effective treatment for depression in adolescents and young adults. MBSR is a compound treatment program which contains meditation, body scan, and yoga practices. It would be interesting in future research to begin to determine which components are necessary for the ability of MBSR treatment to reduce depression.

So, relieve depression with Mindfulness-Based Stress Reduction (MBSR) training.

“Through mindfulness, individuals start to see their thoughts as less powerful. These distorted thoughts – such as “I always make mistakes” or “I’m a horrible person” – start to hold less weight. . . watching ourselves think. We ‘experience’ thoughts and other sensations, but we aren’t carried away by them. We just watch them come and go.” – William Marchand

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

Chi X, Bo A, Liu T, Zhang P and Chi I (2018) Effects of Mindfulness-Based Stress Reduction on Depression in Adolescents and Young Adults: A Systematic Review and Meta-Analysis. Front. Psychol. 9:1034. doi: 10.3389/fpsyg.2018.01034

Abstract

Background: Mindfulness as a positive mental health intervention approach has been increasingly applied to address depression in young people. This systematic review and meta-analysis evaluated the effects of mindfulness-based stress reduction (MBSR) in the treatment of depression among adolescents and young adults.

Methods: Electronic databases and references in articles were searched. Randomized controlled trials (RCTs) evaluating MBSR and reporting outcomes for depressive symptoms among young people aged 12 to 25 years were included. Data extraction and risk of bias assessment were conducted by two reviewers independently. Hedges’ gwith a 95% confidence interval was calculated to represent intervention effect.

Results: Eighteen RCTs featuring 2,042 participants were included in the meta-analysis. Relative to the control groups (e.g., no treatment, treatment as usual, or active control), MBSR had moderate effects in reducing depressive symptoms at the end of intervention (Hedges’ g = −0.45). No statistically significant effects were found in follow-up (Hedges’ g = −0.24) due to a lack of statistical power. Meta-regression found that the average treatment effect might be moderated by control condition, treatment duration, and participants’ baseline depression.

Conclusion: MBSR had moderate effects in reducing depression in young people at posttest. Future research is needed to assess the follow-up effects of MBSR on depressive symptoms among adolescents and young adults.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01034/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_686352_69_Psycho_20180626_arts_A

Reduce Anxiety and Depression in Stressed College Students with Mindfulness

July 10, 2018 psyjdc Leave a comment

Reduce Anxiety and Depression in Stressed College Students with Mindfulness

By John M. de Castro, Ph.D.

“Mindfulness is so vital. It’s being right there in the moment. It helps you be successful in everything you do. College students are under a lot of stress — that’s been a given forever. Now, they have the tools in their pocket.” – Cathleen Hardy Hansen

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can be admitted to the best universities and there is a lot of pressure on university students to excel so that they can get the best jobs after graduation. As a result, parents and students are constantly looking for ways to improve student performance in school. The primary tactic has been to pressure the student and clear away routine tasks and chores so that the student can focus on their studies. But, this might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s mental health, well-being, and school performance.

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur. Contemplative practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. So, it would seem important to examine various techniques to relieve the stress and its consequent symptoms in college students.

In today’s Research News article “A Randomized Controlled Trial Comparing the Attention Training Technique and Mindful Self-Compassion for Students with Symptoms of Depression and Anxiety.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00827/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_662896_69_Psycho_20180605_arts_A ), Haukaas and colleagues explore the ability of attention training and mindfulness training to help relieve the anxiety and depression in college students resulting from stress.

They recruited undergraduate and graduate students who self-reported depression, anxiety, and stress. They were randomly assigned to receive 3 group sessions for 45 minutes for three consecutive weeks of either Attention Training or Mindfulness and Self-Compassion training. Each training included daily home practice with pre-recorded audio recordings. Attention training was designed “to strengthen attentional control and promote external focus of attention, to interrupt and break free of the cognitive attentional syndrome, consisting of prolonged worry or rumination, threat monitoring, and different unhelpful coping styles accompanied by a heightened self-focused attention.” Mindfulness and Self-Compassion training consisted of training to pay attention to the present moment and “to relate to oneself in a kinder and more accepting manner.” Training including Loving Kindness Meditation practice. Participants were measured before and after training for depression, anxiety, self-compassion, responses to thoughts, and mindfulness.

They found that both Attention Training and Mindfulness and Self-Compassion training produced significant reductions in general and test anxiety and depression and significant increases in mindfulness, self-compassion, attention flexibility, and self-esteem. The effects were moderate to large indicating fairly powerful effects of the treatments. It should be noted that there wasn’t a control condition and both treatments were associated with significant changes. It is thus possible that confound or bias was present that could account for some or all of the changes. But, the effects were strong and commensurate with previous findings that mindfulness training reduces anxiety and depression and increases self-compassion. Thus, it would appear that the two treatments are effective for improving the psychological health of stressed university students.

So, reduce anxiety and depression in stressed college students with mindfulness and attention training.

“taking time to catch your breath and meditate can help increase students’ overall life satisfaction. We found that underneath the stress that students are experiencing is a deep desire to appreciate life and feel meaningful connections with other people.” – Kamila Dvorakova

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

Haukaas RB, Gjerde IB, Varting G, Hallan HE and Solem S (2018) A Randomized Controlled Trial Comparing the Attention Training Technique and Mindful Self-Compassion for Students With Symptoms of Depression and Anxiety. Front. Psychol. 9:827. doi: 10.3389/fpsyg.2018.00827

The Attention Training Technique (ATT) and Mindful Self-Compassion (MSC) are two promising psychological interventions. ATT is a 12-min auditory exercise designed to strengthen attentional control and promote external focus of attention, while MSC uses guided meditation and exercises designed to promote self-compassion. In this randomized controlled trial (RCT), a three-session intervention trial was conducted in which university students were randomly assigned to either an ATT-group (n = 40) or a MSC-group (n = 41). The students were not assessed with diagnostic interviews but had self-reported symptoms of depression, anxiety, or stress. Participants listened to audiotapes of ATT or MSC before discussing in groups how to apply these principles for their everyday struggles. Participants also listened to audiotapes of ATT and MSC as homework between sessions. Participants in both groups showed significant reductions in symptoms of anxiety and depression accompanied by significant increases in mindfulness, self-compassion, and attention flexibility post-intervention. These results were maintained at 6-month follow-up. Improvement in attention flexibility was the only significant unique predictor of treatment response. The study supports the use of both ATT and MSC for students with symptoms of depression and anxiety. Further, it suggests that symptom improvement is related to changes in attention flexibility across both theoretical frameworks. Future studies should focus on how to strengthen the ability for attention flexibility to optimize treatment for emotional disorder.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00827/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_662896_69_Psycho_20180605_arts_A

Improve Cognition in Patients with Major Depression with Yoga

July 3, 2018 psyjdc Leave a comment

Improve Cognition in Patients with Major Depression with Yoga

By John M. de Castro, Ph.D.

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. 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), including impairments in thinking (cognition).

A frequent residual symptom of depression is a decrease in cognitive ability. In today’s Research News article “Improvement in neurocognitive functions and serum brain-derived neurotrophic factor levels in patients with depression treated with antidepressants and yoga.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5914260/ ), Halappa and colleagues examine the ability of yoga practice with and without concurrent treatment with antidepressant drugs to relieve depression and impairment of cognition.

They recruited patients with major depressive disorder who were not being treated with antidepressant drugs. They were randomly assigned to receive either antidepressant drugs alone, yoga therapy alone, or yoga therapy in combination with antidepressant drugs. Yoga practice occurred for 1 hour, twice a week for 12 weeks. Age and education matched healthy individuals were also recruited as control participants. They were assessed before and after treatment for depression and cognitive ability with Rey auditory verbal learning test, digit span test, and Trail Making Test. They also had blood drawn for assay of serum brain-derived neurotrophic factor (BDNF) levels

They found, not surprisingly, that at baseline the patients were significantly more depressed and had significantly poorer cognitive performance and BDNF levels than the healthy controls and that the three experimental groups did not significantly differ. After treatment all three groups showed improvement in cognitive ability and increases in BDNF levels, but the yoga alone and the yoga with antidepressant drugs groups performed significantly better than antidepressant drugs alone group. Importantly, the treated groups cognitive performance levels after treatment were comparable to the levels achieved by the healthy control participants.

These results are interesting and potentially important. They suggest that yoga practice alone or in combination with antidepressant drugs produces better improvements in cognition and brain chemistry than the drugs by themselves. Since yoga plus drugs did not produce greater improvements than yoga alone, and yoga alone produced superior benefits than the drugs alone, it would appear that the drugs are not needed and yoga practice by itself is sufficient to improve cognitive performance in patients with major depressive disorder.

This is remarkable and very important. Yoga practice alone can seemingly reverse the deficits in thinking that accompany major depression bring them to normal levels. Yoga practice also does not have the troubling side effects of antidepressant drugs. This study suggests that it a safe and effective treatment. It is also very inexpensive as it can be practiced at home. In addition, yoga has been shown to be effective in the treatment of depression.

So, improve cognition in patients with major depression with yoga.

“These studies suggest that yoga-based interventions have promise as an intervention for depressed mood and that they are feasible for patients with chronic, treatment-resistant depression,” -Nina Vollbehr

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

Halappa, N. G., Thirthalli, J., Varambally, S., Rao, M., Christopher, R., & Nanjundaiah, G. B. (2018). Improvement in neurocognitive functions and serum brain-derived neurotrophic factor levels in patients with depression treated with antidepressants and yoga. Indian Journal of Psychiatry, 60(1), 32–37. http://doi.org/10.4103/psychiatry.IndianJPsychiatry_154_17

Abstract

Context and Aims:

Impairment in cognition is well-known in patients with major depressive disorder. This study examined the effect of yoga therapy with or without antidepressants and antidepressants alone on certain neuropsychological functions in patients with depression. Correlation between changes in neuropsychological test performance and serum brain-derived neurotrophic factor (BDNF) levels was also explored.

Materials and Methods:

Antidepressant-naïve/antidepressant-free outpatients with depression received antidepressant medication alone (n = 23) or yoga therapy with (n = 26) or without (n = 16) antidepressants. Depression was assessed using the Hamilton Depression Rating Scale. Neuropsychological tests included digit-span forward and backward, Rey Auditory Verbal Learning Test, and Trail Making Tests (TMT-A and B). These tests were administered before and 3 months after the treatment in patients, and once in healthy comparison subjects (n = 19).

Statistical Analysis:

Baseline differences were analyzed using independent sample t-test, Chi-square, and one-way ANOVA. Paired t-test was used to analyze the change from baseline to follow-up. Pearson’s correlation was used to explore the association of change between 2 variables.

Results:

Patients had impaired performance on most neuropsychological tests. After 3 months, there was significant improvement – patients’ performance was comparable to that of healthy controls on majority of the tests. Significant inverse correlation was observed between increase in BDNF levels and improvement in TMT “A” duration in Yoga-alone group (r = −0.647; P = 0.009).

Conclusions:

To conclude that, Yoga therapy, alone or in combination with medications, is associated with improved neuropsychological functions and neuroplastic effects in patients with depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5914260/