Depression

Improve Depression with Diabetes with Mindfulness

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Improve Depression with Diabetes with Mindfulness

 

By John M. de Castro, Ph.D.

 

“There is reasonable evidence that mindfulness training decreases anxiety and depression in people with medical conditions like diabetes. On the other hand, what little evidence exists seems to suggest that this alone will not result in better self-management in chronic diseases such as diabetes.” – Andrew Keen

 

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. Mindfulness training is another 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. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. It is a combination of two effective treatments; mindfulness training with Cognitive Behavioral Therapy (CBT). There have been very few controlled trials comparing MBCT to CBT. Such trials could be important for identifying which patients respond best to the which treatment.

 

In today’s Research News article “What works best for whom? Cognitive Behavior Therapy and Mindfulness-Based Cognitive Therapy for depressive symptoms in patients with diabetes.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491069/, Tavote and colleagues conduct a comparison of the effectiveness of Mindfulness Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT) for the treatment of depression that commonly occurs with diabetes patients. They recruited adult patients with Type I or Type II diabetes who were also depressed and randomly assigned them to receive either MBCT or CBT. Both treatments involved 8 weekly meetings lasting 45 to 60 minutes. Homework was also assigned. They were measured at baseline for demographic characteristics, clinical psychological symptoms, personality, and diabetes characteristics. They were also measured for depression prior to and following treatment and 9-months later.

 

They found, as have many others, that both Mindfulness Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT) produced significant reductions in depression in the diabetic patients that were maintained at the 9-month follow-up. They also found that MBCT was superior to CBT in relieving depression in highly educated patients. The two treatments were not significantly different in effectiveness for patients who differed on disease-related characteristics, or on clinical and personality factors.

 

Hence, the results suggest that MBCT and CBT are equivalently effective for depression except for highly educated diabetics who respond best to MBCT. It is not clear why highly educated depressed diabetics respond better when mindfulness training is added to Cognitive Behavioral Therapy (CBT). This should be further investigated in future research studies.

 

So, improve depression with diabetes with mindfulness

 

“Many people with diabetes find it difficult not to judge themselves based on their blood glucose numbers. If the numbers are not in range, that makes them feel bad, and they stop turning to the meter. Mindfulness works not by eliminating guilt, shame, or depression but by guiding people to work though these emotions and accomplish what they need to do to feel better — either by pushing through a workout, passing up an extra piece of cake, or checking blood sugar even though they’re in a bad mood.” – Kara Harrington

 

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

 

Tovote, K. A., Schroevers, M. J., Snippe, E., Emmelkamp, P. M. G., Links, T. P., Sanderman, R., & Fleer, J. (2017). What works best for whom? Cognitive Behavior Therapy and Mindfulness-Based Cognitive Therapy for depressive symptoms in patients with diabetes. PLoS ONE, 12(6), e0179941. http://doi.org/10.1371/journal.pone.0179941

 

Abstract

Objective

Cognitive Behavior Therapy (CBT) and Mindfulness-Based Cognitive Therapy (MBCT) have shown to be effective interventions for treating depressive symptoms in patients with diabetes. However, little is known about which intervention works best for whom (i.e., moderators of efficacy). The aim of this study was to identify variables that differentially predicted response to either CBT or MBCT (i.e., prescriptive predictors).

Methods

The sample consisted of 91 adult outpatients with type 1 or type 2 diabetes and comorbid depressive symptoms (i.e., BDI-II ≥ 14) who were randomized to either individual 8-week CBT (n = 45) or individual 8-week MBCT (n = 46). Patients were followed for a year and depressive symptoms were measured at pre-treatment, post-treatment, and at 9-months follow-up. The predictive effect of demographics, depression related characteristics, and disease specific characteristics on change in depressive symptoms was assessed by means of hierarchical regression analyses.

Results

Analyses showed that education was the only factor that differentially predicted a decrease in depressive symptoms directly after the interventions. At post-treatment, individuals with higher educational attainment responded better to MBCT, as compared to CBT. Yet, this effect was not apparent at 9-months follow-up.

Conclusions

This study did not identify variables that robustly differentially predicted treatment effectiveness of CBT and MBCT, indicating that both CBT and MBCT are accessible interventions that are effective for treating depressive symptoms in broad populations with diabetes. More research is needed to guide patient-treatment matching in clinical practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491069/

Improve Psychological Health in Pregnancy with Mindfulness

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Improve Psychological Health in Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“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

 

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. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone 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. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. 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 further study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/, Aslami and colleagues recruited Islamic women in their 16th to 32nd week of pregnancy and based upon pretesting of anxiety and depression selected two groups; a high anxiety and a high depression group. The groups were then randomly divided into a no-treatment control condition, a 12-week Cognitive Behavioral Therapy (CBT) condition or an 8-week Mindfulness-Based Stress Reduction (MBSR) condition. Traditional MBSR consists of training and practice in meditation, yoga, and body scan. The researchers modified the training protocol to include Islamic spiritual teachings. The CBT and MBSR conditions were assigned home practice for 45 minutes per day for 6 days per week. The participants were measured for anxiety and depression before and after treatment.

 

They found that both the Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR) conditions produced significant decreases in both anxiety and depression while the no-treatment control group did not. In addition, the MBSR condition produced significantly greater reductions than the CBT condition. In fact, MBSR produced a very large reduction, on average, of 79% in anxiety and 81% in depression while CBT produced, on average, only a 45% reduction in anxiety and a 43% reduction in depression. Hence, although CBT was effective, MBSR produced far greater improvements in the pregnant women’s psychological states.

 

These are excellent results. It has been well established that mindfulness training produces significant reductions in anxiety and depression in a wide variety of people with a variety of conditions. But, this trial compared its effectiveness to another known effective treatment, Cognitive Behavioral Therapy (CBT) and found MBSR to be far superior. I am not aware of any other direct comparisons of the two forms of therapy. It is not known, however, if the inclusion of Islamic spiritual teachings added to MBSR’s effectiveness in this group of Islamic women. Regardless, it is clear the MBSR training is highly effective in reducing anxiety and depression in pregnant women. This should be of great assistance in making for a smooth remainder of the pregnancy and delivery and may well produce better outcomes with the infant.

 

So, improve psychological health in pregnancy with mindfulness.

 

“There could not be a better time to learn mindfulness than during pregnancy and early motherhood. For one thing, this is a time when most people have a strong motivation to become the best person they can be in a relatively short period of time. When you realize the full enormity of the responsibility you have taken on by becoming a mom, the primary source of care for another whole human being, not to mention one that you love more than you thought you could ever love, there is a really high level of motivation to try your best to get yourself into the best mental and emotional shape possible.” – Cassandra Vieten

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Aslami, E., Alipour, A., Najib, F. S., & Aghayosefi, A. (2017). A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women . International Journal of Community Based Nursing and Midwifery, 5(2), 144–152.

 

Abstract

Background:

Anxiety and depression during the pregnancy period are among the factors affecting the pregnancy undesirable outcomes and delivery. One way of controlling anxiety and depression is mindfulness and cognitive behavioral therapy. The purpose of this study was to compare the efficiency of mindfulness based on the Islamic-spiritual schemas and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women.

Methods:

The research design was semi-experimental in the form of pretest-posttest using a control group. Among the pregnant women in the 16th to 32nd weeks of pregnancy who referred to the health center, 30 pregnant women with high anxiety level and 30 pregnant women with high depression participated in the research. Randomly 15 participants with high depression and 15 participants with high anxiety were considered in the intervention group under the treatment of mindfulness based on Islamic-spiritual schemes. In addition, 15 participants with high scores regarding depression and 15 with high scores in anxiety were considered in the other group. The control group consisted of 15 pregnant women with high anxiety and depression. Beck anxiety-depression questionnaire was used in two steps of pre-test and post-test. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant.

Results:

The results of multivariate analysis of variance test and tracking Tukey test showed that there was a significant difference between the mean scores of anxiety and depression in the two groups of mindfulness based on spiritual- Islamic scheme (P<0.001) and the group of cognitive behavioral therapy with each other (P<0.001) and with the control group(P<0.001). The mean of anxiety and depression scores decreased in the intervention group, but it increased in the control group.

Conclusion:

Both therapy methods were effective in reduction of anxiety and depression of pregnant women, but the effect of mindfulness based on spiritual- Islamic schemes was more.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/

Change the Brain with Mindfulness

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Change the Brain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The picture we have is that mindfulness practice increases one’s ability to recruit higher order, pre-frontal cortex regions in order to down-regulate lower-order brain activity. In other words, our more primal responses to stress seem to be superseded by more thoughtful ones.” – Tom Ireland

 

There has accumulated a large amount of research demonstrating that meditation has significant benefits for psychological, physical, and spiritual wellbeing. Its positive effects are so widespread that it is difficult to find any other treatment of any kind with such broad beneficial effects on everything from mood and happiness to severe mental and physical illnesses. This raises the question of how meditation could do this. One possibility is that mindfulness practice results in beneficial changes in the nervous system.

 

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

 

The results of the research concerning the changes in the brain that occur with mindfulness practice have not presented a consistent picture. One issue may be the way that mindfulness is measured. This issue was explored in today’s Research News article “A distinction between two instruments measuring dispositional mindfulness and the correlations between those measurements and the neuroanatomical structure.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524689/, Zhuang and colleagues compared Magnetic Resonance Images (MRIs), depression, and emotion regulation, between college students who had been measured for mindfulness with Mindful Attention Awareness Scale (MAAS) to those measured with the Five Factor Mindfulness Questionnaire (FFMQ).

 

They found that higher MAAS scores and FFMQ Describing, Acting with Awareness, and Non-judging scores the lower levels of depression. In addition, higher FFMQ Describing scores were significantly associated with higher emotion regulation. In regard to the brain scans they found that the higher the MAAS score the greater the size of the Precuneus area of the cortex. Mediation analysis demonstrated that the higher the volume of the precuneus cortical region the higher the MAAS score which in turn was associated with lower depression. So, mindfulness as measured by the MAAS was associated greater volume of the precuneus and was responsible for the relationship of the Precuneus volume with depression.

 

In regard to mindfulness measured with the FFMQ and the brain scans they found that the larger the size of the Superior Prefrontal Cortex, the higher the Describing and Non-judging facets and the lower the Non-reacting facet. In addition, the larger the size of the dorsolateral prefrontal cortex and the inferior parietal cortex the higher the Describing FFMQ facet. Mediation analysis demonstrated that the higher the volume of the Superior Prefrontal Cortex the higher the Describing FFMQ facet which in turn predicted higher emotion regulation. So, mindfulness as measured with the Describing FFMQ facet was associated greater size of the Superior Prefrontal Cortex and was responsible for the relationship of the Superior Prefrontal Cortex size with emotion regulation.

 

These results are interesting and suggest that the kind of relationship observed between changes in the brain and mindfulness is affected by the way mindfulness is measured. This could account for some of the conflicting findings in the published research. Also, since the Precuneus is associated with awareness of self, the results suggest that mindfulness as measured by the MAAS mainly measures self-awareness while since the inferior parietal cortex is also associated with awareness of self, the results suggest that mindfulness as measured by the Describing FFMQ facet also measures self-awareness. But the FFMQ mindfulness measure goes further and also documents other abilities. Since, the Prefrontal cortex is associated with attention control and emotion regulation, the results suggest that mindfulness as measured by the Describing and Non-reacting FFMQ facets also measure attention control and emotion regulation.

 

Clearly, mindfulness is associated with different sizes of areas in the brain’s cortical regions. But, even though the brain is different with mindfulness, the types of differences observed depends upon how mindfulness is measured. The Five Factor Mindfulness Questionnaire (FFMQ) measure appears to be superior to the Mindful Attention Awareness Scale (MAAS) as it breaks mindfulness down into component parts providing greater refinement in observed brain changes. These results will be helpful in future research unravelling the relationship of mindfulness to the characteristics of the nervous system.

 

“The practice of mindfulness can train our brains to have a new default. Instead of automatically falling into the stream of past or future rumination that ignites the depression loop, mindfulness draws our attention to the present moment. As we practice mindfulness, we actually start wiring neurons that balance the brain in a way that is naturally an antidepressant. “ – Debbie Hampton

 

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

 

Zhuang, K., Bi, M., Li, Y., Xia, Y., Guo, X., Chen, Q., … Qiu, J. (2017). A distinction between two instruments measuring dispositional mindfulness and the correlations between those measurements and the neuroanatomical structure. Scientific Reports, 7, 6252. http://doi.org/10.1038/s41598-017-06599-w

 

Abstract

The most widely used measurements of mindfulness are the Mindful Attention Awareness Scale (MAAS) and the Five Facet Mindfulness Questionnaire (FFMQ). However, controversies exist regarding the application of these scales. Additionally, the neural mechanisms of dispositional mindfulness have become a topic of interest. In the current study, we used surface-based methodology to identify the brain regions underlying individual differences in dispositional mindfulness in a large non-clinical sample and compared the two instruments for measuring the dispositional mindfulness. The results indicated that the MAAS scores were significantly associated with increased grey matter volumes in the right precuneus and the significant association between the precuneus and depression symptomatology was mediated by MAAS scores. Regarding the FFMQ, the Describing, Nonjudging, and Nonreactivity facets were selectively associated with the cortical volume, thickness and surface area of multiple prefrontal regions as well as the inferior parietal lobule. Importantly, Describing mediated the association between the dorsolateral PFC volume and the cognitive reappraisal strategies of emotion regulation. These results suggested that the MAAS were mainly associated with self-awareness, while the FFMQ facets were selectively involved in emotion regulation, attention control and self-awareness. Therefore, this study characterized the differences in inter-individual variability between the two typical measurements of dispositional mindfulness and the correlations between those measurements and imaging analyses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524689/

Reduce Depression and Anxiety Around Pregnancy with Mindfulness

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Reduce Depression and Anxiety Around Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“By learning mindfulness skills as part of their childbirth education, expectant mothers can reappraise the impending birth as something they can handle instead of viewing it as something to fear.” – Larissa Duncan

 

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. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone 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. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. 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 during the perinatal period.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506176/, Shi & MacBeth reviewed the published research literature on the effectiveness of mindfulness training on the emotional states of women in the perinatal period. They found 18 published studies that employed Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), or mindful yoga as the treatment for anxiety and depression during the perinatal period.

 

They found that the research indicated that mindfulness-based treatments were particularly effective for anxiety and to a lesser extent for depression and its recurrence. The treatments were reported to be safe, with no appreciable negative side effects, and acceptable, with low drop out rates. They note that there is a need for more highly controlled randomized controlled trials that include active control conditions in the future.

 

The results from the summarized 18 studies suggest that mindfulness based interventions are safe and effective treatment for perinatal anxiety and depression. Mindfulness practices have been shown to increase the focus on the present moment. Anxiety tends to revolve around the future while depression appears to revolve around the past. By focusing the individual on what is occurring in the present moment mindfulness training appears to decrease thinking about the past or the future and may thereby reduce anxiety and depression. Mindfulness training has also been shown to reduce the physiological and psychological responses to stress. The reduction in stress responses during the high stress perinatal period may also contribute to the women’s improved mood.

 

So, reduce depression and anxiety around pregnancy with mindfulness.

 

“Since mindfulness has a lot to do with being in touch with the sensations in your body, and being aware, new moms are in a prime state to learn it! In fact, pregnancy and early motherhood, nursing and sleep disturbance, weight gain and weight loss-these all in some way force you to be in your body. For those of us who live most of our lives above our necks, this can actually be a great blessing.” – Cassandra Vieten

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Shi, Z., & MacBeth, A. (2017). The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review. Mindfulness, 8(4), 823–847. http://doi.org/10.1007/s12671-016-0673-y

 

Presenting with common mental health difficulties, particularly depression and anxiety, there is also preliminary evidence that mindfulness-based interventions (MBIs) including mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and integrated mindfulness yoga practices may also be effective in reducing common mental health difficulties during pregnancy. We systematically reviewed and synthesized the current literature on the effectiveness of MBIs in reducing severity of perinatal anxiety and depression. Databases including PubMed, Cochrane Library, IndMED and PsychoInfo were searched for relevant studies. Manual searches were conducted in relevant articles and Google Scholar. Seventeen cohorts representing 18 studies were included. Pre-post effect sizes were reported for both treatment and control groups. Seven randomized controlled trials (RCTs), two non-randomized controlled trials and nine treatment evaluations were included. Maternal participation in an MBI was associated with reductions in perinatal anxiety of moderate to large magnitude. Results for the effect of MBIs on depression were less consistent, with pre-post treatment reductions of moderate magnitude, but no significant differences in depression scores when MBI was compared with a control group. There was some evidence that MBIs were associated with increased mindfulness. Risk of bias in studies was variable. Our review offers preliminary evidence for the effectiveness of MBIs in reducing perinatal anxiety, with more equivocal findings with regard to perinatal depressive symptoms. Further methodologically rigorous evaluation using RCTs and longer follow-up periods are recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506176/

Mindfulness Training Benefits Neurotic Individuals the Most

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Mindfulness Training Benefits Neurotic Individuals the Most

 

By John M. de Castro, Ph.D.

 

“Do you have neurotic tendencies? You might give mindfulness a try. The practice has been shown to help quell the voice of the “obnoxious roommate” in your head. One of the “Big Five” personality traits, neuroticism is characterized by negative affect, rumination on the past and worry about the future, moodiness and loneliness. Practicing mindfulness may be a powerful way for people to detach from common characteristics of neuroticism, including obsessive negative thoughts and worries, and challenges regulating one’s emotions and behavior.” – Carolyn Gregoire

 

We know that people differ in how they interact with the environment and other people. We call these differences personality. Personality characteristics are thought to be relatively permanent traits that form an individual’s distinctive character. Different personalities predict different behaviors and different responses to the environment. This suggests that different personality types might respond differently to mindfulness training.

 

Current psychological research and theorization on personality has suggested that there are five basic personality characteristics. The so called “Big 5” are Extraversion, Agreeableness, Openness to Experience, Conscientiousness, and Neuroticism. Extraversion involves engagement with the external world, particularly other people. Agreeableness involves trust and helpfulness and a positive temperament. Openness to Experience is intellectual curiosity and is associated with creativity and a preference for novelty and variety. Conscientiousness involves planning, organization, dependability and self-discipline. Finally, Neuroticism involves moodiness, negative emotions, and a tendency to perceive even minor things as threatening or impossible. It is thought that most individual personalities can be captured by these five characteristics.

 

It has been shown that people high in mindfulness are also high in the “Big 5” traits of Conscientiousness, and Neuroticism.  It is possible that people high in these traits are more susceptible to the effects of mindfulness training. In today’s Research News article “For Whom Does Mindfulness-Based Stress Reduction Work? Moderating Effects of Personality.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506177/, Nyklíček, I., & Irrmischer examine whether the effectiveness of mindfulness training is affected by the individual’s personality. They recruited adults and provided them with Mindfulness-Based Stress Reduction (MBSR) program. MBSR consists of meditation, yoga and body scan and training occurs over 8 weeks in 2.5-hour weekly sessions with daily homework assignments. Before training their personality was measured and before and after training and 3-months later, they were measured for anxiety and depression.

 

They found that as has been previously demonstrated MBSR resulted in substantial significant reductions in anxiety and depression after training and these mood states continued to improve and were even lower 3 months later. They then tested for mediation effects to determine if personality characteristics affected the MBSR reductions in anxiety and depression. They found that the personality characteristic of neuroticism accentuated the effect such that the higher the levels of neuroticism the greater the reductions in anxiety and depression produced by MBSR. This mediation effect, however, was in part due to the fact that high neuroticism was related to higher depression and anxiety. When they controlled for the levels of depression and anxiety present when the study began, the mediation effect for depression was no longer significant while neuroticism continued to mediate the effect of MBSR on anxiety.

 

So, they found that MBSR training produces a long-lasting reduction in anxiety and depression. The effect of MBSR on depression occurs equally regardless of personality characteristics. On the other hand, MBSR training reduces anxiety to a greater extent in people high in neuroticism. By focusing attention more on the present moment, MBSR training reduces the past orientation that energizes depression and the future orientation that fuels anxiety. It appears to have its effect on anxiety magnified in highly neurotic people. Neuroticism involves a tendency to perceive even minor things as threatening. Focusing on the present moment interrupts seeing future threat and thereby may make the neuroticism less impactful.

 

So, mindfulness training benefits neurotic individuals the most.

 

“By the posture, by the action,
By eating, seeing, and so on,
By the kind of states occurring,
May temperament be recognized.” – Path of Purification

 

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

 

Nyklíček, I., & Irrmischer, M. (2017). For Whom Does Mindfulness-Based Stress Reduction Work? Moderating Effects of Personality. Mindfulness, 8(4), 1106–1116. http://doi.org/10.1007/s12671-017-0687-0

 

Abstract

The aim of the present study was to examine potentially moderating effects of personality characteristics regarding changes in anxious and depressed mood associated with Mindfulness-Based Stress Reduction (MBSR), controlling for socio-demographic factors. Meditation-naïve participants from the general population self-presenting with psychological stress complaints (n = 167 participants, 70% women, mean age 45.8 ± 9.3 years) were assessed in a longitudinal investigation of change in mood before and after the intervention and at a 3-month follow-up. Participants initially scoring high on neuroticism showed stronger decreases in both anxious and depressed mood (both p < 0.001). However, when controlled for baseline mood, only the time by neuroticism interaction effect on anxiety remained significant (p = 0.001), reflecting a smaller decrease in anxiety between pre- and post-intervention but a larger decrease in anxiety between post-intervention and follow-up in those with higher baseline neuroticism scores. Most personality factors did not show moderating effects, when controlled for baseline mood. Only neuroticism showed to be associated with delayed benefit. Results are discussed in the context of findings from similar research using more traditional cognitive-behavioral interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506177/

Mindfulness-Based Cognitive Therapy is Effective Regardless of Teacher Competence

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Mindfulness-Based Cognitive Therapy is Effective Regardless of Teacher Competence

 

By John M. de Castro, Ph.D.

 

 “Over the past 15 years, the results of numerous randomized controlled trials have demonstrated that MBCT can be a powerful intervention for people who have experienced clinical depression three or more times. Evidence indicates MBCT may reduce the rate of relapse for individuals with recurrent depression by 50%. MBCT has also been applied to mood and anxiety concerns other than depression, with reported success.” – Good Therapy .org

 

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 and usually treated with anti-depressive medication. But, of patients treated initially with antidepressant drugs only about a third attained remission of the depression. After repeated and varied treatments including antidepressant drugs, therapy, exercise etc. only about two thirds of patients attained remission. Also, many patients who achieve remission have relapses and recurrences of the depression. In addition, antidepressant drugs often have troubling side effects and can lose effectiveness over time.

 

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. Mindfulness training is another 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. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. MBCT is usually delivered by trained certified teachers but is fairly scripted and standardized. So, it is unclear what the importance of the level of teacher training and competence is.

 

In today’s Research News article “Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506231/, Huijbers and colleagues examine the importance of the competence of the MBCT teacher in the effectiveness of MBCT for depression. They recruited patients who had had at least 3 episodes of depression, were in remission, taking antidepressants, and were engaged in a Mindfulness Based Cognitive Therapy (MBCT) program. MBCT was delivered in of 8 weekly sessions of 2.5 hours.

 

Patients were measured before and after MBCT training and 15 months later for rumination, self-compassion, mindfulness, cognitive reactivity, depressive symptoms, and depression relapse. The MBCT teachers were assessed for competence by two independent professional evaluators who rated a tape recorded MBCT session for “(1) coverage, pacing, and organization of session curriculum; (2) relational skills; (3) embodiment of mindfulness; (4) guiding mindfulness practices; (5) conveying course themes through interactive inquiry and didactic teaching; and (6) holding of group learning environment.” An overall competence rating was calculated as the sum of the 6 component competence scores.

 

They found that following treatment there were significant increases in patient self-compassion and mindfulness and significant decreases in rumination and cognitive reactivity. They also found that teacher competence did not significantly predict the number of sessions that the patients attended, and patient changes in self-compassion, mindfulness, rumination, and cognitive reactivity, or depression severity. In addition, the likelihood of relapse during the 15 month follow-up period was not significantly related to teacher competence. This was true for the overall competence and for each of the 6 competence domains.

 

These results are quite remarkable and suggest that the level of competence and expertise of the instructors in Mindfulness Based Cognitive Therapy (MBCT) does not affect the patient outcomes. These results are contrary to the recent findings that the level of teacher training with Mindfulness-Based Stress Reduction (MBSR) programs is associated with the effectiveness of the program to reduce stress and improve well-being.

 

It’s difficult to reach firm conclusion from the negative results of the present study as the range of teacher competencies was restricted wherein only 2 teachers were characterized as beginner and 2 as advanced. The lack of effect of teacher competence may also be due to the fact that MBCT programs are highly standardized and scripted by the treatment protocol and that patients are supplied with prerecorded materials for home practice. Nevertheless, the results suggest that only modest teacher competence and training is sufficient, with a standardized program, to produce maximal results.

 

So, it appears that Mindfulness-Based Cognitive Therapy is effective regardless of teacher competence.

 

“MBCT teaches people to pay attention to the present moment, rather than worrying about the past or the future, and to let go of the negative thoughts that can tip them over into depression. It also gives people a greater awareness of their own body, helping them to identify the signs of oncoming depression and ward off the episode before it starts.” – BeMindful

 

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

 

Huijbers, M. J., Crane, R. S., Kuyken, W., Heijke, L., van den Hout, I., Donders, A. R. T., & Speckens, A. E. M. (2017). Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome. Mindfulness, 8(4), 960–972. http://doi.org/10.1007/s12671-016-0672-z

 

Abstract

As mindfulness-based cognitive therapy (MBCT) becomes an increasingly mainstream approach for recurrent depression, there is a growing need for practitioners who are able to teach MBCT. The requirements for being competent as a mindfulness-based teacher include personal meditation practice and at least a year of additional professional training. This study is the first to investigate the relationship between MBCT teacher competence and several key dimensions of MBCT treatment outcomes. Patients with recurrent depression in remission (N = 241) participated in a multi-centre trial of MBCT, provided by 15 teachers. Teacher competence was assessed using the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) based on two to four randomly selected video-recorded sessions of each of the 15 teachers, evaluated by 16 trained assessors. Results showed that teacher competence was not significantly associated with adherence (number of MBCT sessions attended), possible mechanisms of change (rumination, cognitive reactivity, mindfulness, and self-compassion), or key outcomes (depressive symptoms at post treatment and depressive relapse/recurrence during the 15-month follow-up). Thus, findings from the current study indicate no robust effects of teacher competence, as measured by the MBI:TAC, on possible mediators and outcome variables in MBCT for recurrent depression. Possible explanations are the standardized delivery of MBCT, the strong emphasis on self-reliance within the MBCT learning process, the importance of participant-related factors, the difficulties in assessing teacher competence, the absence of main treatment effects in terms of reducing depressive symptoms, and the relatively small selection of videotapes. Further work is required to systematically investigate these explanations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506231/

Change Your Brain’s Activity with Mindfulness

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Change Your Brain’s Activity with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The impact that mindfulness exerts on our brain is borne from routine: a slow, steady, and consistent reckoning of our realities, and the ability to take a step back, become more aware, more accepting, less judgmental, and less reactive. Just as playing the piano over and over again over time strengthens and supports brain networks involved with playing music, mindfulness over time can make the brain, and thus, us, more efficient regulators, with a penchant for pausing to respond to our worlds instead of mindlessly reacting.” – Jennifer Wolkin

 

There has accumulated a large amount of research demonstrating that mindfulness practices have significant benefits for psychological, physical, and spiritual wellbeing. Its positive effects are so widespread that it is difficult to find any other treatment of any kind with such broad beneficial effects on everything from mood and happiness to severe mental and physical illnesses. This raises the question of how meditation could do this. The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practices appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

If mindfulness training can alter the nervous system then perhaps simply being a mindful individual will be associated with differences in the same brain regions. This idea was examined in today’s Research News article “Resting Brain Activity Related to Dispositional Mindfulness: a PET Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506209/, Gartenschläger and colleagues recruited normal and psychologically disturbed individuals and measured their levels of mindfulness, depression, and anxiety. The participants then underwent a brain scan for neural activity (Positron Emission Tomography, PET Scan).

 

They found that the higher the participant’s level of mindfulness, the lower the levels of both depression and anxiety. This is not surprising as mindfulness training has been shown repeatedly to produce lower levels of anxiety and depression. They also found that the higher the levels of mindfulness the higher the resting brain activity in the superior parietal lobule and in precuneus and superior parietal lobule and the lower the activity in the inferior frontal orbital gyrus and anterior thalamus.

 

These results are complex but the lower activity in the Thalamus may represent lower levels of general activation of the brain in mindful individuals. Also, the lower activity in the inferior frontal orbital gyrus may represent lower levels of language processing in mindful individuals, possibly indicating less internal language, thinking, with individuals high in mindfulness. In addition, the higher activity in the parietal lobe and precuneus may represent greater activity in the Default Mode Network (DMN) of which these structures are a part. The DMN is associated with a sense of self, self-referential thinking, and mind wandering. This suggests that mindful individuals while at rest, with their eyes closed, may be less activated (more at rest), have less internal language (thought), and have their minds wandering.

 

It may seem counterintuitive that mindful individuals’ minds may be wandering more as mindfulness has been shown to be associated with less mind wandering. But, the situation of lying in a scanner with eyes closed may be one in which discursive thought is perfectly appropriate. In any case, these are interesting results that add to our understanding of the brain systems involved in mindfulness. It will require considerable future research to paint a complete picture of the neural systems underlying mindfulness and being altered by mindfulness training.

 

So, change your brain’s activity with mindfulness.

 

“The practice of mindfulness can train our brains to have a new default. Instead of automatically falling into the stream of past or future rumination that ignites the depression loop, mindfulness draws our attention to the present moment. As we practice mindfulness, we actually start wiring neurons that balance the brain in a way that is naturally an antidepressant.” – Alex Korb

 

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

 

Gartenschläger, M., Schreckenberger, M., Buchholz, H.-G., Reiner, I., Beutel, M. E., Adler, J., & Michal, M. (2017). Resting Brain Activity Related to Dispositional Mindfulness: a PET Study. Mindfulness, 8(4), 1009–1017. http://doi.org/10.1007/s12671-017-0677-2

 

Abstract

Mindfulness denotes a state of consciousness characterized by receptive attention to and awareness of present events and experiences. As a personality trait, it constitutes the ability to become aware of mental activities such as sensations, images, feelings, and thoughts, and to disengage from judgment, conditioned emotions, and their cognitive processing or automatic inhibition. Default brain activity reflects the stream of consciousness and sense of self at rest. Analysis of brain activity at rest in persons with mindfulness propensity may help to elucidate the neurophysiological basis of this important mental trait. The sample consisted of 32 persons—23 with mental disorders and 9 healthy controls. Dispositional mindfulness (DM) was operationalized by Mindful Attention Awareness Scale (MAAS). Brain activity at rest with eyes closed was assessed by fluorodeoxyglucose positron emission tomography (F-18-FDG PET). After adjustment for depression, anxiety, age and years of education, resting glucose metabolism in superior parietal lobule and left precuneus/Brodmann area (BA) 7 was positively associated with DM. Activity of the left inferior frontal orbital gyrus (BA 47) and bilateral anterior thalamus were inversely associated with DM. DM appears to be associated with increased metabolic activity in some core area of the default mode network (DMN) and areas connected to the DMN, such as BA 7, hosting sense of self functions. Hypometabolism on the other hand was found in some nodes connected to the DMN, such as left inferior frontal orbital gyrus and bilateral thalamus, commonly related to functions of memory retrieval, decision making, or outward attention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506209/

Correct Brain Rhythms and Reduce Depression with Mindfulness

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Correct Brain Rhythms and Reduce Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness, or paying full attention to the present moment, can be very helpful in improving the cognitive symptoms of depression.  . . 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. . . We ‘experience’ thoughts and other sensations, but we aren’t carried away by them. We just watch them come and go.” –  Margarita Tartakovsky

 

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 and 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 be applied when the typical treatments fail. Mindfulness training is another 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. Mindfulness training is also known to change the nervous system.

 

The brain shows synchronous activity where large numbers of neural cells are active together in burst. This activity can be recorded in the electroencephalogram (EEG). They appear as oscillations (waves) in the electrical signals that occur at certain frequencies. Over time these frequencies are fairly stable which is reflected in a correlation over time of the waves. This is called Long-Range Temporal Correlations (LRTC). This signal changes with mental illness and brain disease. So, it is reasonable to study the LRTC in depressed patients and the effect of mindfulness training on it.

 

In today’s Research News article “Aberrant Long-Range Temporal Correlations in Depression Are Attenuated after Psychological Treatment.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5488389/, Gärtner and colleagues recruited depressed and healthy control patients and randomly assigned them to receive either 2 weeks of mindfulness training or education on stress reduction. Mindfulness training consisted of two 25-minute guided meditation per day for 6 days per week. The stress reduction education group was asked to rest on the same schedule. Before and after training they were measured for mental illness, depression, and rumination, and the EEG recorded at rest with eyes closed.

 

They found that the there was a significant elevation of the Long-Range Temporal Correlations (LRTC) in the depressed patients in the frontal and temporal cortices. In addition, mindfulness training, but not stress reduction education, produced a significant reduction in both depression and rumination. Further, after mindfulness training there was a significant reduction in the LRTC signal and the larger the reduction in the LRTC the greater the reduction in depression. Hence, they found that depression was associated with heightened neural synchrony and that mindfulness training reduced that synchrony to normal levels while relieving depression. These appeared to be related, as the larger the reduction, normalizing, in the synchrony the greater the reduction in depression.

 

These are interesting results that suggest that mindfulness training changes the brain in beneficial ways for depressed patients, normalizing the brain activity and the depressive symptoms. Mindfulness training has been previously demonstrated to reduce depression. The present results suggest how the training may be altering the brain to relieve depression by correcting aberrant brain activity in the frontal and parietal lobes of the brain. These results, however, only demonstrate that both brain activity and depression change after mindfulness training and does not demonstrate a causal connection between the brain activity and depression. It will remain for future research to investigate whether they are causally connected.

 

So, correct brain rhythms and reduce depression with mindfulness.

 

“Mindfulness practices of MBCT allowed people to be more intentionally aware of the present moment, which gave them space to pause before reacting automatically to others. Instead of becoming distressed about rejection or criticism, they stepped back to understand their own automatic reactions—and to become more attuned to others’ needs and emotions. Awareness gave them more choice in how to respond, instead of becoming swept up in escalating negative emotion.” – Emily Nauman

 

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

 

Gärtner, M., Irrmischer, M., Winnebeck, E., Fissler, M., Huntenburg, J. M., Schroeter, T. A., … Barnhofer, T. (2017). Aberrant Long-Range Temporal Correlations in Depression Are Attenuated after Psychological Treatment. Frontiers in Human Neuroscience, 11, 340. http://doi.org/10.3389/fnhum.2017.00340

 

Abstract

The spontaneous oscillatory activity in the human brain shows long-range temporal correlations (LRTC) that extend over time scales of seconds to minutes. Previous research has demonstrated aberrant LRTC in depressed patients; however, it is unknown whether the neuronal dynamics normalize after psychological treatment. In this study, we recorded EEG during eyes-closed rest in depressed patients (N = 71) and healthy controls (N = 25), and investigated the temporal dynamics in depressed patients at baseline, and after attending either a brief mindfulness training or a stress reduction training. Compared to the healthy controls, depressed patients showed stronger LRTC in theta oscillations (4–7 Hz) at baseline. Following the psychological interventions both groups of patients demonstrated reduced LRTC in the theta band. The reduction of theta LRTC differed marginally between the groups, and explorative analyses of separate groups revealed noteworthy topographic differences. A positive relationship between the changes in LRTC, and changes in depressive symptoms was observed in the mindfulness group. In summary, our data show that aberrant temporal dynamics of ongoing oscillations in depressive patients are attenuated after treatment, and thus may help uncover the mechanisms with which psychotherapeutic interventions affect the brain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5488389/

Improve Major Depression with Yoga

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Improve Major Depression with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga gives us an active role in healing. And by slowing down mental chatter through breath work, it helps facilitate self-acceptance. In other words, through practicing yoga, we become quieter and more grounded. Yoga can help perfectionists as well as those who tend to be self-critical or lack self-confidence,” – Janeen Dr. Locker

 

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 “Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359682/, Streeter and colleagues examine the amount of yoga practice needed to treat depression. They recruited adult patients with major depressive disorder and randomly assigned them to receive either a low or a high dose of Iyengar yoga practice combined with a coherent breathing exercise. Treatment occurred over 12 weeks. The 90-minute practice consisted of 60 minutes of yoga, 10 minutes of relaxation and 20 minutes of breathing exercise. In the low dose condition, there were two 90-minute yoga sessions and 3 60-minute home practices per week for a total of 6 hours of practice per week. In the high dose condition, there were three 90-minute yoga sessions and 4 60-minute home practices per week for a total of 8.5 hours of practice per week. The participants were measured before and after training and during training at weeks 4 and 8 for the presence of mental illness and depression.

 

They found that as practice continued over the 12 weeks there were systematic significant decreases in depression. But, there were no significant differences between the low and high dose groups. There were no adverse events other than mild muscle soreness. Hence, they found that yoga practice was safe and effective, producing clinically significant reductions in depression regardless of dose. There wasn’t a control condition, so it might be argued that the results were due to confounding conditions. But, the fact that previous research with appropriate controls demonstrated that yoga practice reduces depression makes it highly likely that the reduced depression in the current study was produced by the yoga practice.

 

It is interesting that there was no difference between the dosing conditions. It might be argued, however, 6 hours of practice per week for 12 weeks is not a low dose. It is possible that this extensive of a practice is all that is necessary to produce maximal effectiveness. It would be useful if future research employed a range of doses including some much smaller than the current low dose. It would also be important to follow-up the results to investigate the long-term effectiveness of the yoga treatment. Regardless, the present study and previous research make it abundantly clear that yoga practice is a safe and effective treatment for major depression.

 

So, improve major depression with yoga.

 

“Some people who haven’t responded to traditional treatments might do well with yoga, because unlike antidepressant drugs, yoga and deep breathing target the autonomic nervous system. If your autonomic nervous system is balanced out, then the rest of the brain works better,” – Chris Streeter

 

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

Streeter, C. C., Gerbarg, P. L., Whitfield, T. H., Owen, L., Johnston, J., Silveri, M. M., … Jensen, J. E. (2017). Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study. Journal of Alternative and Complementary Medicine, 23(3), 201–207. http://doi.org/10.1089/acm.2016.0140

 

Abstract

Objectives: The aims of this study were to assess the effects of an intervention of Iyengar yoga and coherent breathing at five breaths per minute on depressive symptoms and to determine optimal intervention yoga dosing for future studies in individuals with major depressive disorder (MDD).

Methods: Subjects were randomized to the high-dose group (HDG) or low-dose group (LDG) for a 12-week intervention of three or two intervention classes per week, respectively. Eligible subjects were 18–64 years old with MDD, had baseline Beck Depression Inventory-II (BDI-II) scores ≥14, and were either on no antidepressant medications or on a stable dose of antidepressants for ≥3 months. The intervention included 90-min classes plus homework. Outcome measures were BDI-II scores and intervention compliance.

Results: Fifteen HDG (Mage = 38.4 ± 15.1 years) and 15 LDG (Mage = 34.7 ± 10.4 years) subjects completed the intervention. BDI-II scores at screening and compliance did not differ between groups (p = 0.26). BDI-II scores declined significantly from screening (24.6 ± 1.7) to week 12 (6.0 ± 3.8) for the HDG (–18.6 ± 6.6; p < 0.001), and from screening (27.7 ± 2.1) to week 12 (10.1 ± 7.9) in the LDG (–17.7 ± 9.3; p < 0.001). There were no significant differences between groups, based on response (i.e., >50% decrease in BDI-II scores; p = 0.65) for the HDG (13/15 subjects) and LDG (11/15 subjects) or remission (i.e., number of subjects with BDI-II scores <14; p = 1.00) for the HDG (14/15 subjects) and LDG (13/15 subjects) after the 12-week intervention, although a greater number of subjects in the HDG had 12-week BDI-II scores ≤10 (p = 0.04).

Conclusion: During this 12-week intervention of yoga plus coherent breathing, depressive symptoms declined significantly in patients with MDD in both the HDG and LDG. Both groups showed comparable compliance and clinical improvements, with more subjects in the HDG exhibiting BDI-II scores ≤10 at week 12.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359682/

Improve Major depression with Yoga

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Improve Major depression with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga gives us an active role in healing. And by slowing down mental chatter through breath work, it helps facilitate self-acceptance. In other words, through practicing yoga, we become quieter and more grounded. Yoga can help perfectionists as well as those who tend to be self-critical or lack self-confidence,” – Janeen Locker

 

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 and usually treated with anti-depressive medication. But, of patients treated initially with antidepressant drugs only about a third attained remission of the depression. After repeated and varied treatments including antidepressant drugs, therapy, exercise etc. only about two thirds of patients attained remission. Also, many patients who achieve remission have relapses and recurrences of the depression. In addition, antidepressant drugs often have troubling side effects and can lose effectiveness over time.

 

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. Mindfulness training is another 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. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. Aerobic exercise has also been found to relieve depression. Yoga practice in many ways is ideal as it is both a mindfulness practice and an exercise and it can be practiced in groups or individually at home. It has also been shown to reduce depression.

 

In today’s Research News article “Treating major depression with yoga: A prospective, randomized, controlled pilot trial.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354384/

Prathikanti and colleagues recruited patients with mild to moderate major depression who were not currently taking anti-depressive medications and randomly assigned them to receive 8 weeks of either 90 minutes twice weekly of Hatha yoga practice or a wait list control that received 90 minutes twice weekly of education on the history of yoga. The participants were measured before during, and after treatment for depression, cognitive ability, psychiatric symptoms, self-efficacy, and self-esteem. They found that the yoga group had a significantly greater decline in depression and increase in self-esteem than the education control group and 60% of the yoga group, compared to 10% of the education group, achieved clinical remission of depression. No adverse effects were reported.

 

The results of this randomized controlled clinical trial suggest that yoga practice is safe and effective in relieving depression when used as the sole treatment. The fact that 60% of the yoga practice participants achieved clinically significant remission of their depression is particularly heartening. Unfortunately, this was a pilot study and no follow up measurements were taken, so it cannot be determined whether the effects endure. Regardless, it appears that yoga can be successfully applied as a monotherapy for mild to moderate major depression.

 

So, improve major depression with yoga.

 

“Available reviews of a wide range of yoga practices suggest they can reduce the impact of exaggerated stress responses and may be helpful for both anxiety and depression. In this respect, yoga functions like other self-soothing techniques, such as meditation, relaxation, exercise, or even socializing with friends.” – Harvard Mental Health Letter

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

Prathikanti, S., Rivera, R., Cochran, A., Tungol, J. G., Fayazmanesh, N., & Weinmann, E. (2017). Treating major depression with yoga: A prospective, randomized, controlled pilot trial. PLoS ONE, 12(3), e0173869. http://doi.org/10.1371/journal.pone.0173869

 

Abstract

Background

Conventional pharmacotherapies and psychotherapies for major depression are associated with limited adherence to care and relatively low remission rates. Yoga may offer an alternative treatment option, but rigorous studies are few. This randomized controlled trial with blinded outcome assessors examined an 8-week hatha yoga intervention as mono-therapy for mild-to-moderate major depression.

Methods

Investigators recruited 38 adults in San Francisco meeting criteria for major depression of mild-to-moderate severity, per structured psychiatric interview and scores of 14–28 on Beck Depression Inventory-II (BDI). At screening, individuals engaged in psychotherapy, antidepressant pharmacotherapy, herbal or nutraceutical mood therapies, or mind-body practices were excluded. Participants were 68% female, with mean age 43.4 years (SD = 14.8, range = 22–72), and mean BDI score 22.4 (SD = 4.5). Twenty participants were randomized to 90-minute hatha yoga practice groups twice weekly for 8 weeks. Eighteen participants were randomized to 90-minute attention control education groups twice weekly for 8 weeks. Certified yoga instructors delivered both interventions at a university clinic. Primary outcome was depression severity, measured by BDI scores every 2 weeks from baseline to 8 weeks. Secondary outcomes were self-efficacy and self-esteem, measured by scores on the General Self-Efficacy Scale (GSES) and Rosenberg Self-Esteem Scale (RSES) at baseline and at 8 weeks.

Results

In intent-to-treat analysis, yoga participants exhibited significantly greater 8-week decline in BDI scores than controls (p-value = 0.034). In sub-analyses of participants completing final 8-week measures, yoga participants were more likely to achieve remission, defined per final BDI score ≤ 9 (p-value = 0.018). Effect size of yoga in reducing BDI scores was large, per Cohen’s d = -0.96 [95%CI, -1.81 to -0.12]. Intervention groups did not differ significantly in 8-week change scores for either the GSES or RSES.

Conclusion

In adults with mild-to-moderate major depression, an 8-week hatha yoga intervention resulted in statistically and clinically significant reductions in depression severity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354384/