Depression

Relieve Major Depression with Yoga

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Relieve Major 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 Mental Health Letter

 

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 “Adjunctive yoga vs. health education for persistent major depression: a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548599/ ), Uebelacker and colleagues recruited patients with Major Depressive Disorder (MDD) who were being treated with antidepressant medications and randomly assigned them to receive either 10 weeks of Hatha Yoga or a Health Education Workshop. Yoga classes included breathing exercises, meditation, and postures, and met for 80 minutes, twice a week for 10 weeks. Participants were encouraged to also practice at home. Health education classes included presentations on alcohol, nicotine, and caffeine; being a smart patient; brain diseases; cancer prevention; diabetes; nutrition; germs, colds, and the flu; physical activity; sleep; physical pain, prevalence and causes of depression; and protecting your heart and met for 60 minutes, twice a week for 10 weeks. Participants were encouraged to also study at home. Participants were measured before and after treatment and 3 and 6 months later for depression, physical health, and physical activity.

 

They found that at the end of training there was no significant difference between the groups in depression, but over the following 3 and 6 months, the yoga practice group significantly decreased in depression levels with moderate effect size while the health education group did not. In addition, over the 3 and 6 months follow-up period a greater percentage of participants in the yoga group no longer met the criterion for clinical depression. There were no significant changes in physical health and no adverse events recorded. So, yoga practice was found to be a safe and effective for major depression even in combination with antidepressant medication.

 

It is important to note that the yoga group continued to practice at home after the 10 week training period averaging 36 and 34 minutes of practice per week over the 3 and 6 months follow-up periods. It is not known but suspected that the improvements in depression over this period may have been due to the continued practice. It is also important to note that this study was of excellent quality with an equivalent control condition. This is rare in this kind of research and greatly strengthens the conclusions. Hence, it appears that yoga practice helps to relieve depression in patients with Major Depressive Disorder (MDD) even with continued antidepressant medication.

 

So, relieve major depression with yoga.

 

“yoga classes dramatically reduced levels of depression—so much so that afterward most of the research subjects wouldn’t have qualified as depressed enough to participate in the study in the first place.” – Jessica Berger Gross

 

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

 

Uebelacker, L. A., Tremont, G., Gillette, L. T., Epstein-Lubow, G., Strong, D. R., Abrantes, A. M., … Miller, I. W. (2017). Adjunctive yoga vs. health education for persistent major depression: a randomized controlled trial. Psychological Medicine, 47(12), 2130–2142. http://doi.org/10.1017/S0033291717000575

 

Abstract

Background

The objective of this study was to determine whether hatha yoga is an efficacious adjunctive intervention for individuals with continued depressive symptoms despite antidepressant treatment.

Methods

We conducted a randomized controlled trial of weekly yoga classes (n = 63) vs. health education classes (Healthy Living Workshop, or HLW; n = 59) in individuals with elevated depression symptoms and antidepressant medication use. HLW served as an attention-control group. The intervention period was 10 weeks, with follow-up assessments 3 and 6 months afterwards. The primary outcome was depression symptom severity assessed by blind rater at 10 weeks. Secondary outcomes included depression symptoms over the entire intervention and follow-up periods, social and role functioning, general health perceptions, pain, and physical functioning.

Results

At 10 weeks, we did not find a statistically significant difference between groups in depression symptoms (b=−0.82, SE=0.88, p=0.36). However, over the entire intervention and follow-up period, when controlling for baseline, yoga participants showed lower levels of depression than HLW participants (b = −1.38, SE = 0.57, p = 0.02). Fifty-one percent of yoga participants demonstrated a response (≥ 50% reduction in depression symptoms) at 6 month-follow-up, compared to 31% of HLW participants (OR = 2.31; p = 0.04). Yoga participants showed significantly better social and role functioning and general health perceptions over time.

Conclusions

Although we did not see a difference in depression symptoms at the end of the intervention period, yoga participants showed fewer depression symptoms over the entire follow-up period. Benefits of yoga may accumulate over time.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548599/

 

Improve Employee Mental Health with Internet-Based Mindfulness Training

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Improve Employee Mental Health with Internet-Based Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Mindfulness can only attain sustainable success in the business world if its benefits are optimized and its risks minimized. Participants in mindfulness practices in the workplace must engage voluntarily and proactively if their endeavors are to bear fruit.” – David Brendel

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological and physical health. Indeed, the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the work environment. But, more than half of employees in the U.S. and nearly 2/3 worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired physical and mental health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. Devoting time during the busy workday can be difficult. Mindfulness training over the internet is an alternative training for people who find face-to-face training difficult and inconvenient. Online mindfulness training has shown great promise with effectiveness equivalent to face-to-face training.

 

In today’s Research News article “Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5739441/ ), Stratton and colleagues review, summarize, and perform a meta-analysis of the effectiveness of employee health mental programs implemented over the internet (E-Health Programs) to reduce symptoms of depression, anxiety, and/or stress. They identified 22 randomized controlled trials, with 11 employing Cognitive Behavioral Therapy (CBT), 6 employing stress reduction programs, and 6 employing mindfulness-based interventions.

 

They found that the Cognitive Behavioral Therapy (CBT) and the stress reduction programs were significantly effective in improving depression, anxiety, and/or stress in the workers, but the effect sizes were small to moderate. On the other hand, the mindfulness-based interventions produced large significant reductions in depression, anxiety, and/or stress. The effect sizes for mindfulness-based interventions were significantly larger than those for CBT or stress reduction programs.

 

The results suggest that programs implemented over the internet and designed to improve mental health in workers are effective in improving depression, anxiety, and/or stress. The results further suggest that mindfulness-based programs are significantly more effective. Mindfulness training has been frequently demonstrated to reduce depression, anxiety, and/or stress in general or clinical populations. So, it’s ability to do so here is not surprising but suggests that it is also effective when delivered over the internet. This is important as internet delivery does not detract from workplace time, is convenient for the employees, and is relatively inexpensive for the employer to implement.

 

So, improve employee mental health with internet-based mindfulness training.

 

“injecting a corporate culture of mindfulness not only improves focus, but the ability to manage stress and how employees work together.” – Science Daily

 

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

 

Elizabeth Stratton, Amit Lampit, Isabella Choi, Rafael A. Calvo, Samuel B. Harvey, Nicholas Glozier. Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis. PLoS One. 2017; 12(12): e0189904. Published online 2017 Dec 21. doi: 10.1371/journal.pone.0189904

 

Abstract

Background

Many organisations promote eHealth applications as a feasible, low-cost method of addressing mental ill-health and stress amongst their employees. However, there are good reasons why the efficacy identified in clinical or other samples may not generalize to employees, and many Apps are being developed specifically for this group. The aim of this paper is to conduct the first comprehensive systematic review and meta-analysis evaluating the evidence for the effectiveness and examine the relative efficacy of different types of eHealth interventions for employees.

Methods

Systematic searches were conducted for relevant articles published from 1975 until November 17, 2016, of trials of eHealth mental health interventions (App or web-based) focused on the mental health of employees. The quality and bias of all identified studies was assessed. We extracted means and standard deviations from published reports, comparing the difference in effect sizes (Hedge’s g) in standardized mental health outcomes. We meta-analysed these using a random effects model, stratified by length of follow up, intervention type, and whether the intervention was universal (unselected) or targeted to selected groups e.g. “stressed”.

Results

23 controlled trials of eHealth interventions were identified which overall suggested a small positive effect at both post intervention (g = 0.24, 95% CI 0.13 to 0.35) and follow up (g = 0.23, 95% CI 0.03 to 0.42). There were differential short term effects seen between the intervention types whereby Mindfulness based interventions (g = 0.60, 95% CI 0.34 to 0.85, n = 6) showed larger effects than the Cognitive Behaviour Therapy (CBT) based (g = 0.15, 95% CI 0.02 to 0.29, n = 11) and Stress Management based (g = 0.17, 95%CI -0.01 to 0.34, n = 6) interventions. The Stress Management interventions however differed by whether delivered to universal or targeted groups with a moderately large effect size at both post-intervention (g = 0.64, 95% CI 0.54 to 0.85) and follow-up (g = 0.69, 95% CI 0.06 to 1.33) in targeted groups, but no effect in unselected groups.

Interpretation

There is reasonable evidence that eHealth interventions delivered to employees may reduce mental health and stress symptoms post intervention and still have a benefit, although reduced at follow-up. Despite the enthusiasm in the corporate world for such approaches, employers and other organisations should be aware not all such interventions are equal, many lack evidence, and achieving the best outcomes depends upon providing the right type of intervention to the correct population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5739441/

Reduce Depression During and After Pregnancy with Mindfulness

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Reduce Depression During and After Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness practice, when attention increases in one area of life, the awareness expands in many other areas, as well. A mother who is able to care for and attend to her own vulnerabilities will have much more access to those very same skills as a parent.” – Sonya Dimidjian

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment. The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Hence, it is clear that there is a need for methods to treat depression during and after pregnancy.

 

Since, many drugs can affect the fetus, non-pharmacological treatments for depression are preferable. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. Mindfulness-Based Cognitive Therapy (MBCT) was specificly developed to treat depression and consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying depression. So, it would make sense to further study the effectiveness of MBCT for depression during the perinatal period.

 

In today’s Research News article “Staying Well during Pregnancy and the Postpartum: A Pilot Randomized Trial of Mindfulness Based Cognitive Therapy for the Prevention of Depressive Relapse/Recurrence.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718345/ ), Dimidjian and colleagues recruited pregnant women with Major Depressive Disorder and randomly assigned them to receive either treatment as usual or to Mindfulness-Based Cognitive Therapy (MBCT). MBCT was modified for pregnant women and administered for 2 hours, once a week, for 8 weeks and home practice was assigned. The women were measured for depression before and after treatment and at 1 and 6 months after birth.

 

In regards to depression, they found that relapse rates for depression over the 6-month follow-up period were significantly lower for the MBCT group; 18% vs. 50% for treatment as usual. In addition, the MBCT group had significantly lower levels of depression after treatment. Although the differences were not significant the MBCT group took fewer antidepressant medications and had fewer visits for therapy. A goal of this pilot research study was to assess the acceptability of the program and compliance with its requirements. They found that 89% completed the MBCT program and home practice occurred on over 70% of the available days. In addition, the women reported a high degree of satisfaction with the program.

 

These are impressive results for a pilot study and should provide the encouragement to perform a large randomized controlled clinical trial with an active control group. The results suggest that MBCT treatment is a safe and effective treatment for perinatal depression and has high acceptability and compliance among pregnant women. Hence it is a promising treatment for perinatal depression.

 

So, reduce depression during and after pregnancy with mindfulness.

 

“Not only does cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up—benefits that are well-documented among other groups of people—it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

 

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

 

Dimidjian, S., Goodman, S. H., Felder, J., Gallop, R., Brown, A. P., & Beck, A. (2016). Staying Well during Pregnancy and the Postpartum: A Pilot Randomized Trial of Mindfulness Based Cognitive Therapy for the Prevention of Depressive Relapse/Recurrence. Journal of Consulting and Clinical Psychology, 84(2), 134–145. http://doi.org/10.1037/ccp0000068

Abstract

Objective

Clinical decision-making regarding the prevention of depression is complex for pregnant women with histories of depression and their healthcare providers. Pregnant women with histories of depression report preference for non-pharmacological care, but few evidence-based options exist. Mindfulness-based cognitive therapy has strong evidence in the prevention of depressive relapse/recurrence among general populations and indications of promise as adapted for perinatal depression (MBCT-PD). With a pilot randomized clinical trial, our aim was to evaluate treatment acceptability and efficacy of MBCT-PD relative to treatment as usual (TAU).

Methods

Pregnant adult women with depression histories were recruited from obstetrics clinics at two sites and randomized to MBCT-PD (N= 43) or TAU (N=43). Treatment acceptability was measured by assessing completion of sessions, at-home practice, and satisfaction. Clinical outcomes were interview-based depression relapse/recurrence status and self-reported depressive symptoms through 6-months postpartum.

Results

Consistent with predictions, MBCT-PD for at-risk pregnant women was acceptable based on rates of completion of sessions and at-home practice assignments, and satisfaction with services was significantly higher for MBCT-PD than TAU. Moreover, at-risk women randomly assigned to MBCT-PD reported significantly improved depressive outcomes compared to participants receiving TAU, including significantly lower rates of depressive relapse/recurrence and lower depressive symptom severity during the course of the study.

Conclusions

MBCT-PD is an acceptable and clinically beneficial program for pregnant women with histories of depression; teaching the skills and practices of mindfulness meditation and cognitive behavioral therapy during pregnancy may help to reduce the risk of depression during an important transition in women’s lives.

Public Health Significance Statement

This study’s findings support MBCT-PD as a viable non-pharmacological approach to preventing depressive relapse/recurrence among pregnant women with histories of depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718345/

Reduce Depression by Improving Brain Responses with Mindfulness

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Reduce Depression by Improving Brain Responses with Mindfulness

 

By John M. de Castro, Ph.D.

 

“If we accept that you can’t control your thoughts or feelings, but rather focus on cultivating your awareness of them, and regulate their impact, without getting caught up with them, then life can be far less stressful. The important thing is to realize that the content of our thoughts and emotions is less important than how we let them affect us.” – Ray Williams

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. 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.

 

One of the characterizing features of depression is flat affect. Depressed individuals do not appear to react emotionally to either positive or negative events in their lives. Good things do not improve their mood and bad things don’t worsen it. This lack of reactivity tends to interfere with recovery from depression. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. This suggests that mindfulness training may help to reverse the flat affect, the lack of emotional reactivity.

 

In today’s Research News article “Brief training in mindfulness may normalize a blunted error-related negativity in chronically depressed patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709439/ ), Fissler and colleagues employed an electrical response of the brain to the commission of an error, error related negativity, to measure non-reactivity in depressed patients and the effects of mindfulness training on this response.

 

They recruited adult depressed patients and healthy individuals as control participants. They were measured for depression both by clinical interview and self-report. Participants were asked to perform a sustained attention to response task in which single digits were presented and the participants were asked to press a space bar for all digits except the number 3. During the task, the Electroencephalogram (EEG) was recorded from the scalp to measure brain responses. The brain frontal lobe electrical response on correct trials was compared to that when errors were committed to measure error related negativity. After baseline measurement, the depressed patients were randomly assigned to either receive 2 weeks of mindfulness training or rest. The mindfulness training consisted of 25 minutes of meditation twice a day for 6 days per week. Resting depressed patients were asked to schedule rest periods on a similar schedule.

 

They found that the depressed patients were slower and made more errors on the sustained attention to response task than the health controls. In addition, the depressed patients had a significantly lower error related negativity in the EEG from the frontal lobe than controls, signifying less reactivity in these patients. They further compared the depressed patients who meditated to those who rested and found that both groups had decreased depression levels, but the meditators had significantly greater reductions in depression. Importantly, the depressed patients who meditated had an increased error related negativity response while the depressed patients who rested did not. This indicates that meditation improved depression and the brains electrical responses to events.

 

These are interesting and important results. It is well established that mindfulness training (meditation) significantly improves depression and this effect was repeated in this study. But, the results also suggest that meditation changes the brain of depressed patients, making it more responsive to environmental events. This suggests that meditation training may, to some extent, reverse the flat affect of depressed patients and that this occurs in combination with decreased depression. It cannot be established from this study if there is a causal connection between the flat affect and depression improvements. But, it is clear that mindfulness training (meditation) improves both.

 

So, reduce depression by improving brain responses with mindfulness.

 

“When unhappy or stressful thoughts occur, rather than taking them personally and merely reacting, mindfulness teaches you to observe such thoughts with friendly curiosity. You learn to catch negative patterns of thinking before they put you into a downward spiral. Over time, mindfulness can bring about long-term changes in mood and increased levels of happiness.” Sylvia Brafman

 

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

 

Fissler, M., Winnebeck, E., Schroeter, T. A., Gummbersbach, M., Huntenburg, J. M., Gärtner, M., & Barnhofer, T. (2017). Brief training in mindfulness may normalize a blunted error-related negativity in chronically depressed patients. Cognitive, Affective & Behavioral Neuroscience, 17(6), 1164–1175. http://doi.org/10.3758/s13415-017-0540-x

 

Abstract

The error-related negativity (ERN), an evoked-potential that arises in response to the commission of errors, is an important early indicator of self-regulatory capacities. In this study we investigated whether brief mindfulness training can reverse ERN deficits in chronically depressed patients. The ERN was assessed in a sustained attention task. Chronically depressed patients (n = 59) showed significantly blunted expression of the ERN in frontocentral and frontal regions, relative to healthy controls (n = 18). Following two weeks of training, the patients (n = 24) in the mindfulness condition showed a significantly increased ERN magnitude in the frontal region, but there were no significant changes in patients who had received a resting control (n = 22). The findings suggest that brief training in mindfulness may help normalize aberrations in the ERN in chronically depressed patients, providing preliminary evidence for the responsiveness of this parameter to mental training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709439/

Depressions Interferes with Mindfulness’ Relationship to Smoking

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Depressions Interferes with Mindfulness’ Relationship to Smoking

 

By John M. de Castro, Ph.D.

 

“There’s lots of self-judgment that goes on when you’re trying to do something difficult, like trying to quit smoking. Also, if we judge others, that can get us riled up, which can lead to smoking. We teach it as a way to learn to concentrate more but also to let go of judgment. When people have a craving, they can notice if they’re resisting or beating themselves up.” – Judson Brewer

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But, smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful.

 

Cigarette smoking is highly related to depression. In addition, mindfulness has been shown to be negatively related to depression and is also effective in assisting smokers in quitting. Hence, examining the relationships between mindfulness, depression, and cigarette smoking may lead to better methods to quit smoking and prevent relapse. In today’s Research News article “Facets of Mindfulness Mediate the Relationship between Depressive Symptoms and Smoking Behavior.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5222556/ ), Vinci and colleagues investigate the relationships of the facets of mindfulness of observing, describing, acting with awareness, and accepting without judging, with depression and cigarette smoking.

 

They recruited undergraduate students who smoked cigarettes and had them complete online measures of mindfulness, cigarette use, smoking consequences, and depression. They found that the higher the students’ levels of depression the more cigarettes they smoked per day. They also found that the higher the level of mindfulness accepting without judging the fewer cigarettes they smoked per day and the lower the expectation that smoking would decrease negative emotions like depression.

 

Applying a sophisticated multiple mediation statistical method to the data they found that depression increased mindful observing which in turn increased the expectation that smoking would improve negative emotions. In addition, they found that depression decreased mindfully accepting without judging which in turn decreased the expectation that smoking would improve negative emotions. In other words, depression worked through mindfulness facets to alter the students’ expectation that they would feel emotionally better after smoking.

 

The results suggest that the greater the students’ levels of mindful accepting without judging the lower the expectation that smoking would make them feel better and the lower their cigarette consumption. This suggests that improving the students’ abilities to accept things as they are without judgement would lower their beliefs that smoking a cigarette will make them feel emotionally better which would act, in turn, to decrease cigarette consumption. They also suggest that depression interferes with this by lowering the ability of accepting without judging and thereby increase the expectation of feeling better. In other words, depression interferes with mindfulness’ ability to lower expectations and cigarette smoking.

 

This study is correlative, so causal relationships cannot be concluded. But, the fact that mindfulness training has been found previously to both lower depression and cigarette smoking, suggests that the relationships discovered in the present study reflect underlying causal connections. These results provide a clearer perspective on how mindfulness training may improve the ability to overcome drug addictions, doing so by reducing the expectation that the drug will help them feel better emotionally.

 

So, increase mindfulness and reduce smoking.

 

“I noticed that people who have addictions and those who teach mindfulness speak the same language. Mindfulness teachers will tell you that stress is caused by craving. If you can let go of that craving, then your stress will dissolve, and practicing mindfulness is the way to do that.” – Judson Brewer

 

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

 

Vinci, C., Spears, C. A., Peltier, M. R., & Copeland, A. L. (2016). Facets of Mindfulness Mediate the Relationship between Depressive Symptoms and Smoking Behavior. Mindfulness, 7(6), 1408–1415. http://doi.org/10.1007/s12671-016-0582-0

 

Abstract

The relationship between cigarette smoking and depressive symptoms is well-established. Dispositional mindfulness has been associated with lower depressive symptoms, lower smoking dependence, and higher odds of smoking cessation. Given that mindfulness is multi-faceted, the current study examined which facets of mindfulness might mediate the relationship between depressive symptoms and smoking behavior. Participants (n = 72) completed the Smoking Consequences Questionnaire (SCQ), Center for Epidemiologic Studies Depression Scale (CESD), and Kentucky Inventory of Mindfulness Skills (KIMS; subscales-Observe, Describe, Acting with Awareness, Accepting without Judgment), and indicated number of cigarettes smoked per day (CPD). Simple mediation models (followed by multiple mediation when more than one facet was significant) tested whether mindfulness facets mediated the relationship between CESD and smoking behavior (CPD and SCQ subscales). Results indicated that 1) lower depressive symptoms were associated with higher Accepting without Judgment, which was related to lower Negative Reinforcement expectancies, 2) lower depressive symptoms were associated with increased Describe, which was associated with greater perceived Negative Consequences, 3) lower depressive symptoms were associated with higher Accepting without Judgment, which was associated with lower Negative Consequences expectancies, and 4) higher depressive symptoms were associated with higher scores on Observe, which related to both greater Positive Reinforcement and Negative Consequences expectancies. Greater Accepting without Judgment and Describe aspects of mindfulness may serve as protective factors in the relationship of depressive symptoms and smoking.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5222556/

Reduce Postpartum Depression with Mindfulness

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Reduce Postpartum Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Interventions that bring a deeper sense of self-knowing and well-being to mothers allow them, in turn, to model this behavior for their children. We can’t possibly have the foresight to see how it ripples out from there, but we can be sure that it does.” – Heather Grimes

 

The birth of a child is most often a joyous occasion. But, often the joy turns to misery. Immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

 

Postpartum depression is treated much like depression in general with medications, psychotherapy, and support groups. But these methods often don’t work or have troublesome side effects. So, alternative treatments are needed. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of mindfulness training as a treatment for postpartum depression.

 

In today’s Research News article “The effectiveness of mindfulness training on reducing the symptoms of postpartum depression.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586989/, Sheydaei and colleagues recruited new mothers who exhibited symptoms of depression and randomly assigned them to receive either treatment as usual or an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). MBCT consists of mindfulness training and Cognitive Behavioral Therapy (CBT) to investigate and alter aberrant thought patterns underlying depression. MBCT was administered for 2 hours, once a week, for 8 weeks. The women were measured for depression before and after treatment.

 

They found that after treatment the control group showed no change in depression while, on the other hand, the women who received the MBCT program had a significant, 25%, reduction in depression. The conclusions from this study need to be tempered with the fact that the control condition did not have an active treatment. So, placebo effects, demand characteristics, experimenter bias, etc. could be alternative explanations. But, it has been well established that mindfulness training in general and MBCT in particular are effective in treating depression. So, it is likely that MBCT effectively reduced the depression in these women with newborn children. Hence, MBCT appears to be a safe and effective treatment for postpartum depression. Mindfulness training might be employed not only to treat postpartum depression but also as a preventative measure.

 

So, reduce postpartum depression with mindfulness.

 

“mothers in the mindfulness group seemed to have had a better psychological experience of labor compared to the control group. They reported feeling greater “self-efficacy” during childbirth (the sense that they were able to handle it rather than feeling afraid), and lower symptoms of depression after the workshop and several weeks after childbirth.” – Jenn Knudsen

 

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

 

Sheydaei, H., Ghasemzadeh, A., Lashkari, A., & Kajani, P. G. (2017). The effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Electronic Physician, 9(7), 4753–4758. http://doi.org/10.19082/4753

 

Abstract

Background and Aim

Postpartum depression is one of the prevalent disorders among new mothers. The present research aimed to examine the effectiveness of mindfulness training on reducing the symptoms of postpartum depression.

Method

The present quasi-experimental research was conducted on 410 new mothers in Shahid Chamran Hospital, Tehran in 2014. Using the Beck Depression Inventory (BDI), Structured Clinical Interview and Psychological Clinical Diagnosis, 67 mothers were selected and then randomly divided into experimental and control groups, each of which with 32 applicants. Afterwards, the experimental group received mindfulness training for 8 sessions, each lasting for two hours while the control group received no training. The data were analyzed through descriptive statistics and Analysis of Covariance (ANCOVA) in SPSS, version 20.

Results

Results showed that based on Beck Inventory, the scores for the experimental group in post-test were significant (p<0.001), compared to those for the control group. Also, it was revealed that pre- and posttest mean scores for postpartum depression in the control group were 25.81 and 25.12 respectively while the scores for the experimental group were 24.75 and 18.5 respectively. Since the posttest mean score in the experimental group was lower than that in the pretest, it can be said that the treatment, i.e., mindfulness training, was effective in reducing depression symptoms in mothers.

Conclusion

Findings proved that mindfulness training was effective in reducing the symptoms of postpartum depression in new mothers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586989/

Improve Emotions of Ethnically Diverse At-Risk Students with Mindfulness

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Improve Emotions of Ethnically Diverse At-Risk Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“There is plenty of evidence available now that demonstrates the value of teaching mindfulness to young people, and many of the benefits of mindfulness are skills and dispositions that are especially helpful in the context of education. Mindfulness practices help children improve their ability to pay attention, by learning to focus on one thing (e.g., breath, sound) while filtering out other stimuli. Mindfulness also provides kids with skills for understanding their emotions and how to work with them.” – Sarah Beach

 

Adolescence should be a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. These executive functions are an important foundation for success in the complex modern world. But, adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. These difficulties can be markedly amplified by negative life events during childhood.

 

At-risk youth confront unique pressures that have been linked to poor psychosocial outcomes, impaired academic performance, and maladaptive behaviors such as substance use and delinquency. These risk factors may include language barriers, low SES, parents’ own involvement in high risk or illegal behavior, restrictive or neglectful parenting, and home environments that expose children to alcohol and substance abuse. Mindfulness training has been found to be helpful for adolescents and also to improve performance in school. So, it is possible that mindfulness training would be helpful for at-risk adolescents.

 

In today’s Research News article “A School-Based Mindfulness Pilot Study for Ethnically Diverse At-Risk Adolescents.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809539/pdf/nihms652885.pdf, Bluth and colleagues recruited adolescents who were attending an alternative high school for troublesome and at-risk students. They were randomly assigned to receive either and 11-week class of mindfulness training or substance abuse training. The mindfulness training included body scan, sitting meditation, lovingkindness practice, walking meditation and mindful movement. The substance abuse training consisted of lectures designed to help adolescents address drug use and co-occurring life problems. The students were measured before and after the trainings for class attendance, retention, program acceptability, mindfulness, self-compassion, social connectedness, anxiety, depression, and perceived stress.

 

At the beginning of the mindfulness training there was considerable resistance and acting out. But, by the end of training the students responded that the class was helpful and wanted it to continue. They also found that the mindfulness training produced significant improvements in the students’ depression and anxiety levels. Mindfulness training has in the past been repeatedly shown to help relieve depression and anxiety. But, it is an important finding that it can do so in these difficult to treat at-risk adolescents. So, the study showed that mindfulness training was feasible and acceptable to these at-risk adolescents and produced improvements in their negative emotions.

 

The results are encouraging. These troubled youths are extremely difficult to work with and treat and that was reflected in the negative behaviors at the beginning of the class. But, by the end of the class the students found the mindfulness training useful and there were fairly large improvements in anxiety and depression. There were trends for other improvements and a larger future trial may be able to demonstrate other benefits of the mindfulness training. Although it was clear that mindfulness training is not a panacea for troubled youths, it can be helpful and provide space for them to destress and explore their inner lives.

 

So, improve emotions of ethnically diverse at-risk students with mindfulness.

 

“But a growing body of evidence suggests that mindfulness practice could be beneficial to teens, helping them cultivate empathy, as well as skills for concentration and impulse control. In short, mindfulness can help adolescents navigate the challenges of adolescence.” Sarah Beach

 

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

 

Bluth, K., Campo, R. A., Pruteanu-Malinici, S., Reams, A., Mullarkey, M., & Broderick, P. C. (2016). A School-Based Mindfulness Pilot Study for Ethnically Diverse At-Risk Adolescents. Mindfulness, 7(1), 90–104. http://doi.org/10.1007/s12671-014-0376-1

 

Adolescence is a transitional period marked by rapid physical, behavioral, emotional, and cognitive developmental changes. In addition to these normative development changes, adolescents also face a multitude of contextual stressors such as academic pressures at school, changing relationships with peers, and all too often, unstable family life characterized by divorce, frequent moves, income and occupational changes, and disruptions in family routines. 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.

Given the need to better understand both the implementation and potential benefit of mindfulness programs for at-risk youth, we conducted a randomized pilot study to investigate the feasibility and acceptability of such an intervention with ethnically diverse, primarily Hispanic youth enrolled in an alternative high school. We specifically examine intervention effects on psychosocial wellbeing and school performance relative to the control group, a class which focused on substance abuse prevention.

this study contributes to the literature by confirming the feasibility and acceptability of a mindfulness intervention with this population, and expands our knowledge on what works.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809539/pdf/nihms652885.pdf

Improve Mental Illness with Yoga

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Improve Mental Illness with Yoga

 

By John M. de Castro, Ph.D.

 

“for the general person, yoga greatly enhances mental health: mood, sense of self, motivation, sense of inner direction and purpose, as well as physical health—and physical health is so important for mental health.“– Eleanor Criswell

 

Yoga is a complex of practices including postures, movements, breathing practices and meditation. Although its benefits have been touted for centuries, it is only recently that scientific study was verified these benefits. Yoga practice has been repeatedly demonstrated in research studies to be beneficial for the psychological and physical health of the practitioners. It appears to be helpful for both healthy individuals and those suffering from physical and mental health issues.

 

In today’s Research News article “The Efficacy of Body-Oriented Yoga in Mental Disorders: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400032/ ),

Klatte and colleagues review, summarize, and perform a meta-analysis of the published research literature on effects of yoga practice on a variety of mental health problems. They focused on randomized controlled studies with adults suffering from psychiatric problems. They identified 25 published studies that met their criteria, including treatment of depression, schizophrenia, dependency, post-traumatic Stress Disorder (PTSD), and other mental illnesses.

 

They found that yoga practice produced, on the whole, large and significant improvements in the symptoms of the mental illnesses even in comparison to active control groups such as attention training and exercise. The beneficial effects of yoga practice were comparable to those produced by psychotherapy. But, the combination of yoga practice with psychotherapy produced even greater effects.

 

These are exciting and compelling findings that yoga practice is an effective treatment for mental illness on a par with individual psychotherapy. But, yoga practice has the advantage of being relatively inexpensive, can be practiced at home or in groups, and after a few weeks of instruction can be carried on without a therapist present. In addition, it can supplement traditional psychotherapy potentiating its effectiveness.

 

It would appear that the exercise component of yoga practice is not essential for its effectiveness as exercise only control groups show benefits but significantly less than the yoga practice groups. This suggests that the improvement of mindfulness that occurs in yoga practice has an additional beneficial role to play in treating mental illness. The combination of exercise with mindfulness training that occur with yoga  practice appears to be particularly effective in treating mental illnesses. These results suggest that yoga practice is safe and effective and should applied either as a stand-alone treatment or be combined with more traditional treatments.

 

So, improve mental illness with yoga.

 

“It will come as no surprise that the various forms of yoga have long been acknowledged as allies in mastering the mind and coping with stress. Science is Increasingly validating those claims, especially for depression, schizophrenia, anxiety, PTSD (post-traumatic stress disorder), and ADHD (attention deficit hyperactivity disorder).” – Mental Health America

 

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

 

Klatte, R., Pabst, S., Beelmann, A., & Rosendahl, J. (2016). The Efficacy of Body-Oriented Yoga in Mental Disorders: A Systematic Review and Meta-Analysis. Deutsches Ärzteblatt International, 113(12), 195–202. http://doi.org/10.3238/arztebl.2016.0195

Abstract

Background

The efficacy of body-oriented yoga in the treatment of mental disorders has been investigated in numerous studies. This article is a systematic review and meta-analysis of the relevant publications.

Methods

All studies in which the efficacy of hatha-yoga, i.e., body-oriented yoga with asanas and pranayama, was studied in adult patients suffering from a mental disorder (as diagnosed by ICD or DSM criteria) were included in the analysis. The primary endpoint was disorder-specific symptom severity. The publications were identified by a systematic search in the PubMed, Web of Science, PsycINFO and ProQuest databases, supplemented by a search with the Google Scholar search engine and a manual search in the reference lists of meta-analyses and primary studies, as well as in specialized journals.

Results

25 studies with a total of 1339 patients were included in the analysis. A large and significant effect of yoga was seen with respect to the primary endpoint (symptom severity) (Hedges’ g = 0.91; 95% confidence interval [0.55; 1.28]; number needed to treat [NNT]: 2.03), with substantial heterogeneity (I2 = 69.8%) compared to untreated control groups. Small but significant effects of yoga were also seen in comparison with attention control (g = 0.39; [0.04; 0.73]; NNT: 4.55) and physical exercise (g = 0.30; [0.01; 0.59]; NNT: 5.75); no difference in efficacy was found between yoga and standard psychotherapy (g = 0.08; [-0.24; 0,40]; NNT: 21.89). In view of the relatively high risk of bias, these findings should be interpreted with caution.

Conclusion

Body-oriented yoga with asanas and pranayama as central components is a promising complementary treatment for mental disorders and should be investigated in further high-quality studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400032/

Improve Posttraumatic Stress Disorder (PTSD) with Mindfulness

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Improve Posttraumatic Stress Disorder (PTSD) with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mind-body exercise offers a low-cost approach that could be used as a complement to traditional psychotherapy or drug treatments. These self-directed practices give PTSD patients control over their own treatment and have few side effects.” – Sang Kim

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. But, only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life. For military personnel, it’s much more likely for PTSD to develop with about 11%-20% of those who have served in a war zone developing PTSD.

 

PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

 

Obviously, these are troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD including, Mindfulness Based Stress Reduction (MBSR). It includes body scan, meditation, and yoga practices. Although MBSR has been used successfully to treat PTSD, it has always been implemented in addition to other treatments and has never been examined as a stand-alone treatment. In today’s Research News article “Mindfulness-Based Stress Reduction (MBSR) as a Standalone Intervention for Posttraumatic Stress Disorder after Mixed Traumatic Events: A Mixed-Methods Feasibility Study.” See summary below or view the full text of the study at: http://journal.frontiersin.org/article/10.3389/fpsyg.2017.01407/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_388380_69_Psycho_20170912_arts_A, Müller-Engelmann and colleagues examine the efficacy of MBSR as a stand-alone treatment for PTSD.

 

They recruited adult male and female patients who were diagnosed with PTSD as the result of experiencing interpersonal violence.  Mindfulness Based Stress Reduction (MBSR) was administered in 8 weekly-2 ½ hour sessions in combination with required practice at home. The patients were measured before and after treatment for mindfulness, depression, PTSD symptoms, trauma symptoms, and experience with the program. They were also interviewed after the program regarding their experience with and feelings about the program.

 

They found that following treatment there were significant reductions in PTSD symptoms and in depression. Also, they found that the greater the increase in mindfulness the greater the decrease in PTSD symptoms. During post-treatment interviews the patients reported an overall increase in their sense of well-being. No adverse reactions were observed. Hence, MBSR treatment appeared to be an acceptable, safe, and effective stand-alone treatment for PTSD.

 

It should be noted that there was not a control or comparison condition. This markedly limits the ability to conclude that MBSR was responsible for the improvements. There is a need to perform a randomized controlled clinical trial with an active control condition. In addition, over a third of the patients who started the program dropped out. The drop-outs had significantly greater PTSD symptoms than the completers. This suggests that modifications of the program must be undertaken to keep the most severely affected patients in the program. Nevertheless, the findings are encouraging and justify further research.

 

So, improve posttraumatic stress disorder (PTSD) with mindfulness.

 

“People who practiced mindfulness meditation about half an hour a day for 8 weeks saw a change in several brain structures related to learning, memory, emotion, and the fear response. These are all things that play a role in post-traumatic stress responses.” – Sara Staggs

 

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

 

Müller-Engelmann M, Wünsch S, Volk M and Steil R (2017) Mindfulness-Based Stress Reduction (MBSR) as a Standalone Intervention for Posttraumatic Stress Disorder after Mixed Traumatic Events: A Mixed-Methods Feasibility Study. Front. Psychol. 8:1407. doi: 10.3389/fpsyg.2017.01407

 

Abstract

Objectives: There is promising evidence that mindfulness-based interventions are effective in reducing the symptoms of posttraumatic stress disorder (PTSD). However, until now, studies have often lacked a full clinical PTSD assessment, and interventions are often administered in addition to other interventions. This study examined the feasibility of mindfulness-based stress reduction (MBSR) as a standalone intervention in patients with PTSD who have experienced mixed traumatic events.

Method: Fourteen patients participated in 8 weeks of MBSR. The patients were assessed prior to treatment, post-treatment and at a 1-month follow-up through self-ratings (e.g., the Davidson Trauma Scale) and the Clinician-Administered PTSD Scale to determine the effects of the intervention. Furthermore, after the intervention, the patients participated in qualitative interviews regarding their experiences with MBSR and their ideas for future improvements.

Results: Nine patients finished the program, and these patients considered the exercises to be applicable and helpful. In the Clinician-Administered PTSD Scale, we found large effects regarding the reduction of PTSD symptoms among completers (Cohen’s d = 1.2). In the Davidson Trauma Scale, the effect sizes were somewhat lower (Cohen’s d = 0.6) but nevertheless confirmed the efficacy of MBSR in reducing PTSD symptoms. In the qualitative interviews, the patients reported an augmentation of wellbeing and improvement regarding the handling of difficult situations and more distance from the traumatic event.

Conclusion: Despite the large effects, the high dropout rates and the results of the post-treatment interviews suggest that the intervention should be better adapted to the needs of PTSD patients, e.g., by giving more information regarding the exercises and by including shorter exercises to manage acute distress.

http://journal.frontiersin.org/article/10.3389/fpsyg.2017.01407/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_388380_69_Psycho_20170912_arts_A