Depression

Mindfulness Training is Effective when Learned over the Internet.

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Mindfulness Training is Effective when Learned over the Internet.

 

By John M. de Castro, Ph.D.

 

“online mindfulness/stress management programs can be as effective as real-world programs, delivered at a fraction of the cost. . . . online programs could make mindfulness more accessible to underserved populations—as long as they have a computer and an Internet connection.” – Hooria Jazaieri

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness Training, Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This produces costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules. As a result, there has been attempts to develop on-line mindfulness training programs. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts. Many believe that the presence of a therapist is a crucial component to the success of the programs and the lack of an active therapist in on-line programs may greatly reduce their effectiveness.

 

In today’s Research News article “Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes?” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010616/

Fish and colleagues review and summarize the published research literature on the effectiveness of mindfulness therapies delivered online. They identified 9 randomized controlled trials of web-based mindfulness training. “All interventions introduced participants to some form of mindfulness practice including body scans, mindfulness of breathing, mindful movement and loving kindness” meditation.

 

They found that the studies reported that mindfulness training resulted in large improvements in mindfulness, reductions in stress, and clinically significant reductions in depression and anxiety. A large proportion of participants, 83%, continued practice after training ceased and the beneficial effects of the practice were still significant as much as 6-months later. These are impressive results which are comparable to the effects reported for therapist guided mindfulness training for stress, anxiety, and depression.  The studies, however, generally used weak control conditions and there is a need to continue the research with stronger research designs.

 

These are important findings in that mindfulness therapies were successfully implemented on-line. Web-based therapy allows for widespread, inexpensive, and convenient distribution of the treatment programs thereby opening up treatment to individuals who live in remote areas, cannot afford traditional therapist led treatment, or do not have the time to come repeatedly to a clinic during the workday. Hence, mindfulness training can be provided at low cost to widespread communities and individuals at their convenience. This greatly magnifies the potential societal benefits of mindfulness training; improving health and well-being.

 

So, mindfulness training is effective when learned over the internet.

 

“One of the benefits of living in a digital age is that we can pretty much access whatever we want. That is certainly true of meditation. Every major meditation center or university has an online component, offering you virtual courses, guided meditations, information on retreats and workshops. “ – Mindful

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Fish, J., Brimson, J., & Lynch, S. (2016). Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes? Mindfulness, 7(5), 1011–1023. http://doi.org/10.1007/s12671-016-0548-2

 

Abstract

New cost-effective psychological interventions are needed to contribute to treatment options for psychiatric and physical health conditions. This systematic review aims to investigate the current literature on one potentially cost-effective form of mindfulness-based therapy, those delivered through technological platforms without any mindfulness facilitator input beyond the initial design of the programme. Three electronic databases (Ovid Medline, PsychINFO and Embase) were searched for relevant keywords, titles, medical subject headings (MeSH) and abstracts using search terms derived from a combination of two subjects: ‘mindfulness’ and ‘technology’. Overall, ten studies were identified. The majority of studies were web-based and similar in structure and content to face-to-face mindfulness-based stress reduction courses. Clinical outcomes of stress (n = 5), depression (n = 6) and anxiety (n = 4) were reported along with mindfulness (n = 4), the supposed mediator of effects. All eight studies that measured significance found at least some significant effects (p < .05). The highest reported effect sizes were large (stress d = 1.57, depression d = .95, both ps > .005). However, methodological issues (e.g. selection bias, lack of control group and follow-up) which reflect the early nature of the work mean these largest effects are likely to be representative of maximal rather than average effects. Whilst there are important differences in the construction, length and delivery of interventions, it is difficult to draw firm conclusions about the most effective models. Suggestions of key characteristics are made though, needing further investigation preferably in standardised interventions. Given the existing research and the speed at which technology is making new platforms and tools available, it seems important that further research explores two parallel lines: first, refinement and thorough evaluation of already established technology-based mindfulness programmes and second, exploration of novel approaches to mindfulness training that combine the latest technological advances with the knowledge and skills of experienced meditation teachers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010616/

 

Reduce Grief with Mindfulness

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Reduce Grief with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Releasing the grief we carry is a long, tear-filled process. Yet it follows the natural intelligence of the body and heart. Trust it, trust the unfolding. Along with meditation, some of your grief will want to be written, to be cried out, to be sung, to be danced. Let the timeless wisdom within you carry you through grief to an open heart.” – Jack Kornfield

 

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

 

A stillbirth can be a devastating loss as the joyous anticipation of a new baby is replaced by a death. This can produce intense mental challenges. Mindfulness training is known to help with coping with emotions and stress, and is very effective for depression. Hence, mindfulness training may be helpful in coping with the grief following a stillbirth. In today’s Research News article “Mindfulness-based Intervention for Perinatal Grief Education and Reduction among Poor Women in Chhattisgarh, India: a Pilot Study.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367631/

Roberts and Montgomery recruited women, aged 18 to 35 years, in rural India who had a history of stillbirth. They provided them with a one session per week for 5-weeks of mindfulness training based upon Mindfulness-Based Stress Reduction (MBSR). This included meditation, body scanning, and yoga practices and had additional education materials on risk factors for stillbirth and prevention strategies. The women were measured before and after the intervention and 6-weeks later for grief, anxiety and depression symptoms, satisfaction with life, religious coping, social support, and mindfulness. During the 6-week follow up period the women practiced daily at home.

 

They found, not surprisingly, that at baseline the women had clinically significant levels of anxiety, depression, and grief. After the mindfulness training, there were significant improvements in grief, anxiety and depression, religious coping, and the mindfulness facets of describe and acting with awareness. Hence the mindfulness training appeared to increase mindfulness and help relieve some of the psychological consequences of having a stillbirth. This could be important as the grief and depression after stillbirth can be severe. Relieving these consequences may be very helpful to the women learning to cope with and move past their tragic loss.

 

These are encouraging results, but must be viewed as preliminary pilot data. There was no control condition so, there are a large number of possible other explanations for the results including placebo effects, attentional effects, experimenter bias, etc. The data do support, however, conducting a larger randomize controlled clinical trial. Such research could lead to mindfulness training being used to assist in coping with loss and grief.

 

So, reduce grief with mindfulness.

 

“Mindful grieving informs us to allow ourselves to feel what is there, without judgment. For me, there was sadness there and I needed to nonjudgmentally acknowledge it, feel it, and let it be. It was important in that moment that I didn’t resist it or strive to make it any different, but just feel it as it was. Ronald Pies, M.D. wrote to us, “Having problems means being alive”, and I’d add “Being alive, means grieving loved ones who pass.” Grief is a natural part of the human experience.” – Elisha Goldstein

 

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

Roberts, L., & Montgomery, S. (2016). Mindfulness-based Intervention for Perinatal Grief Education and Reduction among Poor Women in Chhattisgarh, India: a Pilot Study. Interdisciplinary Journal of Best Practices in Global Development, 2(1), 1.

 

Abstract

Introduction

Stillbirth is a significant public health problem in low-to-middle-income countries and results in perinatal grief, often with negative psychosocial impact. In low-resource settings, such as Chhattisgarh, India, where needs are high, it is imperative to utilize low-cost, effective interventions. Mindfulness-based stress reduction (MBSR) is an empirically sound intervention that has been utilized for a broad range of physical and mental health problems, and is adaptable to specific populations. The main objective of this pilot study was to explore the feasibility and effectiveness of a shortened, culturally adapted mindfulness-based intervention to address complex grief after stillbirth.

Methods

We used an observational, pre-post-6-week post study design. The study instrument was made up of descriptive demographic questions and validated scales and was administered as a structured interview due to low literacy rates. We used a community participatory approach to culturally adapt the five-week mindfulness-based intervention and delivered it through two trained local nurses. Quantitative and qualitative data analyses explored study outcomes as well as acceptability and feasibility of the intervention.

Results

29 women with a history of stillbirth enrolled, completed the pretest and began the intervention; 26 completed the five-week intervention and post-test (89.7%), and 23 completed the six-week follow-up assessment (88.5%). Pretest results included elevated psychological symptoms and high levels of perinatal grief, including the active grief, difficulty coping, and despair subscales. General linear modeling repeated measures was used to explore posttest and six-week follow up changes from baseline, controlling for significantly correlated demographic variables. These longitudinal results included significant reduction in psychological symptoms; four of the five facets of mindfulness changed in the desired direction, two significantly; as well as significant reduction in overall perinatal grief and on each of the three subscales.

Discussion

The shortened, culturally adapted, mindfulness-based intervention pilot study was well received and had very low attrition. We also found significant reductions of perinatal grief and mental health symptoms over time, as well as a high degree of practice of mindfulness skills by participants. This study not only sheds light on the tremendous mental health needs among rural women of various castes who have experienced stillbirth in Chhattisgarh, it also points to a promising effective intervention with potential to be taken to scale for wider delivery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367631/

Remove Mental Sets to Improve Depression with Mindfulness

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Remove Mental Sets to Improve Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“This new evidence for mindfulness-based cognitive therapy … is very heartening. While MBCT is not a panacea, it does clearly offer those with a substantial history of depression a new approach to learning skills to stay well in the long-term.” – Willem Kuyken

 

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 it’s 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. Additionally, drugs often have troubling side effects and can lose effectiveness over time. So, it is imperative that safe and effective treatments be identified that can be applied as stand-alone treatments or applied when the typical treatments fail and/or when side effects are unacceptable.

 

One of the characterizing features of depression is aberrant thought processes. The thinking of individuals with depression is often fraught with rumination, repeated reflection on troubling past events, and inability to suppress irrelevant thoughts or expectancies. These ruminative and irrelevant thoughts can produce an inaccurate and dark interpretation of reality. That these thought processes may be at the core of depression is evidenced by the fact that altering them with cognitive behavioral therapy is quite effective in relieving 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. The combination of mindfulness training with cognitive behavioral therapy is a technique called Mindfulness-Based Cognitive Therapy (MBCT). It was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate depression. MBCT has been found to reduce depression alone or in combination with anti-depressive drugs and can even be effective even in the cases where drugs fail,.

 

In today’s Research News article “Mindfulness-based cognitive therapy for depressed individuals improves suppression of irrelevant mental-sets,” see summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357295/

Greenberg and colleagues investigate the thought processes of depressed individuals, the effects of Mindfulness-Based Cognitive Therapy (MBCT) on these thought processes and the relationship of the altered thought processes to the relief of depression. They recruited mildly to moderately depressed adults and randomly assigned them to either receive treatment as usual or 8-weeks of MBCT. They were measured before and after treatment for depression, rumination, and suppression of mental set. This latter measure involved measuring the ability of the participants to move from a rule used repeatedly to solve a simple comparison problem (mental set) to a new one. For example, they were asked to indicate if one to three objects varied in a characteristic, e.g. amount. After repeated trials in which amount was the relevant characteristic, without knowledge of the participants, it was changed to another characteristic smoothness. How long it took the participant to recognize the change to the new rule and begin responding to it was measured.

 

They found, as many previous studies, that Mindfulness-Based Cognitive Therapy (MBCT) produced large and significant relief of depression. Importantly, they also found that MBCT resulted in faster recognition of and response to the changed rule. In other words the MBCT treated participants had improved suppression of mental set. In addition, they found that the greater the improvement in suppressing mental sets the greater the relief of depression. These results strongly suggest that altering thought processes produced by MBCT are at the root of its ability to relieve depression.

 

It has been long suspected that changes in thinking were important for treating depression. The results of the present study provide strong evidence that this is true. They also suggest that being able to move from a single method of thinking to more flexible thinking may be a key. Depressed individuals interpret events in a way that reinforces their depression. By improving their ability to interpret events in different, more realistic, ways, MBCT interrupts the cycle of thinking that maintains the depression and thereby relives the depression.

 

So, remove mental sets to improve depression with mindfulness.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

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

Greenberg, J., Shapero, B. G., Mischoulon, D., & Lazar, S. W. (2017). Mindfulness-based cognitive therapy for depressed individuals improves suppression of irrelevant mental-sets. European Archives of Psychiatry and Clinical Neuroscience, 267(3), 277–282. http://doi.org/10.1007/s00406-016-0746-x

 

Abstract

An impaired ability to suppress currently irrelevant mental-sets is a key cognitive deficit in depression. Mindfulness-based cognitive therapy (MBCT) was specifically designed to help depressed individuals avoid getting caught in such irrelevant mental-sets. In the current study, a group assigned to MBCT plus treatment-as-usual (n = 22) exhibited significantly lower depression scores and greater improvements in irrelevant mental-set suppression compared to a wait-list plus treatment-as-usual (n = 18) group. Improvements in mental-set-suppression were associated with improvements in depression scores. Results provide the first evidence that MBCT can improve suppression of irrelevant mental-sets and that such improvements are associated with depressive alleviation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357295/

Prevent Depression Relapse and Lessen Residual Symptoms with Mindfulness

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Prevent Depression Relapse and Lessen Residual Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“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.” – William Marchand

 

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-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and has been found to reduce depression alone or in combination with anti-depressive drugs and can even be effective even in the cases where drugs fail,.  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate depression.

 

In today’s Research News article “Mindfulness Based Cognitive Therapy for Residual Depressive Symptoms and Relapse Prophylaxis.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706736/

Segal and colleagues reviewed the recent published research literature on the effectiveness of MBCT for depression, remission, and residual symptoms. They indicate that the current research provides evidence that MBCT acts to alter neural structures that are involved in depressive symptoms including increased activations in the insula and prefrontal cortex, which are involved in interoceptive awareness and emotion regulation, processes deficient in depressed individuals. They also report that MBCT has been found to be as effective or perhaps more effective than antidepressant drugs in relieving depression, preventing relapse, and decreasing residual symptoms.

 

The published recent research suggests that MBCT might have its benefits for depression by lowering worry and rumination which are major contributors to depression. MBCT has also been shown to be effective for other mood disorders and for eating disorders, medically ill populations, such as cancer or diabetes, and pain management. In addition, these effects have been shown to occur regardless of whether MBCT is delivered in face-to-face group formats or individually on-line.

 

Hence, the research indicates that MBCT is a highly effective treatment of depression, relapse prevention, and residual symptoms, for other mood disorders, for medical diseases, and for pain. It has been shown to be safe with few if any adverse effects, and can be delivered with cost-effective on-line programs. Much of its effectiveness appears to be from cognitive changes, making the patient more mindful of the present moment and reconfiguring errant thought processes producing reductions in worry and rumination. Thus, a clear case is building that MBCT should be one of the primary treatments used especially for depression.

 

So, prevent depression relapse and lessen residual symptoms with mindfulness.

 

“mindfulness meditation “helps individuals step back from the ruminative thinking processes widely found to underlie a depressive episode.” – “Lara Fielding

 

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

Segal, Z. V., & Walsh, K. M. (2016). Mindfulness Based Cognitive Therapy for Residual Depressive Symptoms and Relapse Prophylaxis. Current Opinion in Psychiatry, 29(1), 7–12. http://doi.org/10.1097/YCO.0000000000000216

 

Key Points

Data from multiple RCTs indicates that MBCT is effective in preventing relapse and reducing residual symptoms in patients with recurrent depression who are in clinical remission.

Studies of the mechanisms of change in MBCT point to reductions in rumination and increases in metacognitive awareness as being consistently associated with clinical benefits

In an effort to reduce barriers to care, MBCT has been adapted for online delivery – Mindful Mood Balance – with early data suggesting good patient engagement and outcomes.

Mindfulness meditation is associated with increased activations in the insula and prefrontal cortex, neurological changes that parallel behavioural changes in interoceptive awareness and emotion regulation.

 

Abstract

Purpose of review

This article reviews the recent evidence for mindfulness based cognitive therapy (MBCT) for patients with residual depressive symptoms or in remitted patients at increased risk for relapse.

Recent findings

Randomized controlled trials have shifted focus from comparing MBCT with treatment-as-usual to comparing MBCT against interventions. These studies have provided evidence for the efficacy of MBCT on par with maintenance antidepressant pharmacotherapy and leading to a relative reduction of risk on the order of 30–40%. Perhaps fuelled by these data, recent efforts have focused on extending MBCT to novel populations, such as acutely depressed patients, those diagnosed with health anxiety, social anxiety, fibromyalgia, or multiple chemical sensitivities as well migrating MBCT to online platforms so that it is more widely available. Neuroimaging studies of patients in structured therapies which feature mindfulness meditation, have reported findings that parallel behavioural changes, such as increased activation in brain regions subsuming self-focus and emotion regulation (prefrontal cortex) and interoceptive awareness (insula).

Summary

The current evidence base for MBCT is strongest for its application as a prophylactic intervention or for residual depressive symptoms, with early data suggesting additional indications outside the mood disorders. Future work will need to address dose-effect relationships between mindfulness practice and clinical benefits as well as establishing the rates of uptake for online MBCT so that its benefits can be compared to in-person groups. Additionally, validating current or novel neural markers of MBCT treatment response will allow for patient matching and optimization of treatment response.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706736/

 

Improve Drug Resistant Major Depressive Disorder with Yoga Breathing Exercises

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Improve Drug Resistant Major Depressive Disorder with Yoga Breathing Exercises

 

By John M. de Castro, Ph.D.

 

“Yoga breathing can help you manage the symptoms of both anxiety and depression. After years of meditating, and learning to observe my anxiety-based depression, I actually recovered from a condition that literally almost killed me. I regained and continue to maintain my optimum mental health with a yoga breathing practice.” – Amy Weintraub

 

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. But, antidepressant 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.

 

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 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. Yoga practice, though, is a combination of practices including postures, meditation, and breathing exercises. Hence, it is not clear which, or which combination of these components is effective for depression. In today’s Research News article “A Breathing-based Meditation Intervention for Patients with Major Depressive Disorder Following Inadequate Response to Antidepressants: A Randomized Pilot Study.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5272872/

Sharma and colleagues perform a controlled pilot test of yogic breathing exercises alone for the treatment of antidepressant drug resistant major depressive disorder.

 

They recruited patients diagnosed with a major depressive disorder who after at least 8 weeks of antidepressant drug treatment did not show a decrease or remission in their depression. The participants were then randomly assigned to either a wait-list control condition or to receive 8 weeks of yogic breathing exercise practice meeting in groups, once a week for 90 minutes and practiced daily at home for 20 to 30 minutes. The intervention consisted of a series of sequential, rhythm-specific breathing exercises that bring practitioners into a restful, meditative state. They were measured prior to and after the intervention and mid-course at 4-weeks into practice for anxiety, depression, suicidal ideation and behavior, medication compliance, and adverse effects.

 

They found that the yogic breathing group had high completion rates and no adverse effects. The intervention group, in comparison to the wait-list control group, had a highly significant, 44% decrease in clinician rated depression, and in self-rated anxiety and depression. Hence, yogic breathing exercises appeared to produce dramatic, clinically significant reductions in depression in patients who were unresponsive to antidepressant drug treatment.

 

These are interesting and exciting findings that simple breathing exercises with no side effects can produce clinically significant relief of antidepressant drug resistant major depressive disorder. It is remarkable that such a simple intervention can have such huge effects on a disorder that is exceedingly difficult to treat. It should be mentioned that the control condition did not receive and additional treatment. So, it is important that this pilot study be followed by a randomized controlled clinical trial that also includes other forms of active treatments such as relaxation or meditation training. This could help reduce confounding and to sort out which components of the yogic breathing exercise were effective.

 

So, improve drug resistant major depressive disorder with yoga breathing exercises.

 

“A powerful tool for preventing the onset of depressed moods in the first place, breath awareness restores energy during acute phases of depression, lightens your emotional load, and creates needed distance from gloomy thoughts. And it complements other healing strategies by providing an underpinning of relaxation and emotional stability.” – Rolf Sovic

 

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

Sharma, A., Barrett, M. S., Cucchiara, A. J., Gooneratne, N. S., & Thase, M. E. (2017). A Breathing-based Meditation Intervention for Patients with Major Depressive Disorder Following Inadequate Response to Antidepressants: A Randomized Pilot Study. The Journal of Clinical Psychiatry, 78(1), e59–e63. http://doi.org/10.4088/JCP.16m10819

 

Abstract

Objective

To evaluate feasibility, efficacy and tolerability of Sudarshan Kriya yoga (SKY) as an adjunctive intervention in patients with major depressive disorder (MDD) with inadequate response to antidepressant treatment.

Method

Patients with MDD (defined by DSM-IV-TR) depressed despite ≥8 weeks of antidepressant treatment were randomized to SKY or a waitlist control (delayed yoga) arm for 8 weeks. The primary efficacy end point was change in 17-item Hamilton Depression Rating Scale (HDRS-17) total score from baseline to 2 months. The key secondary efficacy end points were change in Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) total scores. Analyses of the intent-to-treat (ITT) and completer sample were performed. The study was conducted at the University of Pennsylvania between October 2014 and December 2015.

Results

In the ITT sample (n=25), the SKY arm (n=13) showed a greater improvement in HDRS-17 total score compared to waitlist control (n=12)(−9.77 vs. 0.50, P =.0032). SKY also showed greater reduction in BDI total score versus waitlist control (−17.23 vs. −1.75, P = .0101). Mean changes in Beck Anxiety Inventory (BAI) total score from baseline were significantly greater for SKY than waitlist (ITT mean difference: −5.19; 95% CI −0.93 to −9.34; P = .0097; completer mean difference: −6.23; 95% CI −1.39 to −11.07; P = .0005). No adverse events were reported.

Conclusion

Results of this randomized, waitlist-controlled pilot study suggest the feasibility and promise of an adjunctive SKY-based intervention for patients with MDD who have not responded to antidepressants.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5272872/

Improve Treatment Resistant Depression with Mindfulness

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Improve Treatment Resistant Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. 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.

 

Being depressed and not responding to treatment (Treatment Resistant Depression) 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 Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. In order to identify the best possible treatment, it is particularly important to investigate MBCT’s efficacy for Treatment Resistant Depression relative to other treatments that place equivalent demands upon the patients.

 

In today’s Research News article “A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756643/

Eisendrath and colleagues compared the relative efficacy of MBCT to a structurally equivalent active comparison condition, a Health-Enhancement Program. They recruited adults who were diagnosed with Major Depressive Disorder who were taking antidepressant medication. They were encouraged to continue their antidepressant medication while participating in the study. They were randomly assigned, stratified by gender, to receive 8-weeks of either standard Mindfulness Based Cognitive Therapy (MBCT) treatment or the Health-Enhancement Program. Both groups met once a week for 2 ¼ hours and were assigned 45 minutes of homework 6 days per week. The MBCT program included training in skills to identify cognitive distortions and to disengage from depression-focused ruminative thinking patterns, body scans, sitting meditations, three-minute breathing spaces, and mindful movement. The Health-Enhancement Program included aerobic exercise, functional movement, music therapy, and dietary education. The participants were evaluated for depression levels, and expectancies of treatment effects before and after treatment and mid-treatment (4-weeks).

 

They found that MBCT, in comparison to the Health-Enhancement Program produced a significantly greater reduction in depression (36.6% vs. 25.3%). In addition, MBCT treatment had a significantly greater proportion of patients respond to treatment. MBCT also produced higher, albeit not significantly different, rates of depression remission (22.4%). The two groups did not differ in their expectations that treatment would be successful, suggesting equivalent placebo effects. Hence, MBCT, was found to be superior to a structurally equivalent Health-Enhancement Program treatment in reducing depression in patients with Treatment Resistant Depression (TRD).

 

These are exciting results and strengthen the case that Mindfulness Based Cognitive Therapy (MBCT) is an effective treatment for the very difficult to treat Treatment Resistant Depression. MBCT uses mindfulness training and cognitive training to allow the patients to reprogram their thought patterns and how they interpret experiences, recognizing that their thoughts are only, just that, thoughts and not reflective of their selves. They learn to experience their emotions but adaptively react to them, seeing them as simply experiences that come and go. This helps them release rumination about past and future problems and focus on the present. This appears to go to the core of the psychological aspects of the disorder and greatly enhance the patient’s ability to cope with their depression.

 

So, improve treatment resistant depression with mindfulness.

 

“MBCT enables people to relate mindfully to the self and with others. The key, it seems, lies in the way MBCT enhances relationships: Less stress about relationships in turn helps prevent future episodes of depression.” – 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

Eisendrath, S. J., Gillung, E., Delucchi, K. L., Segal, Z. V., Nelson, J. C., McInnes, L. A., … Feldman, M. D. (2016). A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression. Psychotherapy and Psychosomatics, 85(2), 99–110. http://doi.org/10.1159/000442260

 

Abstract

Background

Due to the clinical challenges of treatment-resistant depression (TRD), we evaluated the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) relative to a structurally equivalent active comparison condition as adjuncts to treatment-as-usual (TAU) pharmacotherapy in TRD.

Methods

This single site, randomized controlled trial compared 8-week courses of MBCT and the Health-Enhancement Program (HEP), comprising physical fitness, music therapy and nutritional education, as adjuncts to TAU pharmacotherapy for outpatient adults with TRD.

The primary outcome was change in depression severity, measured by percent reduction in total score on the 17-item Hamilton Depression Rating Scale (HAM-D17), with secondary depression indicators of treatment response and remission.

Results

We enrolled 173 adults, mean length of current depressive episode was 6.8 years (sd = 8.9). At the end of 8-week treatment, a multivariate analysis showed that relative to the HEP condition, the MBCT condition was associated with a significantly greater mean percent reduction on the HAM-D17 (36.6% versus 25.3%; p=.01) and a significantly higher rate of treatment responders (30.3% versus 15.3%; p=.03). Although numerically superior for MBCT than for HEP, the rates of remission did not significantly differ between treatments (22.4% versus 13.9%; p=.15). In these models, state anxiety, perceived stress, and the presence of personality disorder had adverse effects on outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756643/

Improve Depression and Cognitive Decline with Yoga

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Improve Depression and Cognitive Decline with Yoga

 

By John M. de Castro, Ph.D.

 

“For years, we’ve been told to keep our minds sharp by doing crosswords and playing Sudoku. But yoga and meditation are more effective than memory exercises for combating the mental decline that often precedes Alzheimer’s. People who practised yoga regularly were also less likely to be depressed and anxious, and were better able to cope with stress. Regular practice could be a simple, safe and low-cost solution to improving brain fitness and ward off ageing.” Madlen Davies

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities which decline with age including impairments in memory, attention, and problem solving ability. It is inevitable and cannot be avoided. But there are more serious declines.

 

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. Dementia patients require caregiving particularly in the later stages of the disease. Alzheimer’s disease is the most common type of dementia and accounts for 50 to 70 percent of dementia cases. Other types of dementia include vascular dementia, mixed dementia, dementia with Lewy bodies and frontotemporal dementia. Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and the more-serious decline of dementia. It can involve problems with memory, language, thinking and judgment that are greater than normal age-related changes.

 

There is some hope for age related cognitive decline, however, as there is evidence that they can be slowed. There are some indications that physical and mental exercise can reduce the rate of cognitive decline and lower the chances of dementia. For example, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging. Mindfulness practices have been shown to improve cognitive processes while gentle mindful exercises such as Tai Chi and Qigong have been shown to slow age related cognitive decline.

 

These age-related declines in mental ability are associated with mood disturbance, particularly depression. So, depression is a potentially modifiable risk factor for cognitive decline in aging. In today’s Research News article “The Roles of Exercise and Yoga in Ameliorating Depression as a Risk Factor for Cognitive Decline.” See summary below: Mathersul and Rosenbaum review the published research literature on the effectiveness of yoga and exercise to relieve depression and restrain cognitive decline.

 

They find that the published literature demonstrates that exercise, including aerobic exercise and strength training improve cognitive ability even in younger individuals and also relieves depression. In addition, the published literature demonstrates that yoga practice is also effective in reducing depression and also restraining cognitive decline. The hormonal system particularly the hypothalamic-pituitary adrenal axis that produces cortisol and sympathetic nervous system, involved in the stress response, may be the common intermediaries as both are associated with cognitive decline and depressions and both are reduced by both yoga and exercise. But, this speculation has yet to be definitively tested.

 

These findings are interesting but are correlational and do not demonstrate causal links between yoga and exercise effects on depression and, in turn, age related cognitive decline. It remains to future research to clarify this issue. Regardless, it is clear that both exercise and yoga are effective to reducing depression and cognitive decline in aging, making them excellent practices for healthy aging.

 

So, improve depression and cognitive decline with yoga.

 

“This ancient Indian practice of exercise, breathing, and meditation has been around for about 5,000 years, and now researchers are finding out why millions of Americans practice yoga to ease depression, anxiety, and stress. In fact, the American Yoga Association says just a few minutes of yoga three times every day can balance your body and mind and get your depression on the run.” – Chris Lliades

 

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

Danielle C. Mathersul and Simon Rosenbaum, “The Roles of Exercise and Yoga in Ameliorating Depression as a Risk Factor for Cognitive Decline,” Evidence-Based Complementary and Alternative Medicine, vol. 2016, Article ID 4612953, 9 pages, 2016. doi:10.1155/2016/4612953

 

Abstract

Currently, there are no effective pharmaceutical treatments to reduce cognitive decline or prevent dementia. At the same time, the global population is aging, and rates of dementia and mild cognitive impairment (MCI) are on the rise. As such, there is an increasing interest in complementary and alternative interventions to treat or reduce the risk of cognitive decline. Depression is one potentially modifiable risk factor for cognitive decline and dementia. Notably, exercise and yoga are two interventions known to both reduce symptoms of depression and improve cognitive function. The current review discusses the efficacy of exercise and yoga to ameliorate depression and thereby reduce the risk of cognitive decline and potentially prevent dementia. Potential mechanisms of change, treatment implications, and future directions are discussed.

Feel Depressed About a Disease, Try Mindfulness

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Feel Depressed About a Disease, Try Mindfulness

 

By John M. de Castro, Ph.D.

 

“Depression can be the dead hand of the past. Our longing for what we’re missing has a hold on us. If we feel helpless about our situation and don’t feel we can change it, we are likely to remain depressed. If we can mobilize our feelings of hopefulness, if we see that hope is justified and act on it, then our mood will improve.” – James Gordon

 

Clinically diagnosed depression is the most common form of mental illness, affecting over 6% of the population. In general, it involves feelings of sadness, emptiness or hopelessness, irritability or frustration, loss of interest or pleasure in most or all normal activities, sleep disturbances, tiredness and lack of energy, anxiety, agitation, feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility, suicidal thoughts, and suicide attempts or completed suicide. Needless to say, individuals with depression are miserable and need help.

 

There are numerous causes of depression, one being coping with a chronic physical disease. Indeed, between 9% to 23% of people diagnosed with a chronic physical disease become depressed. Although, there have been many studies of treatments for depression, there are very few that target just patients with physical diseases and comorbid depression. Mindfulness-Based Cognitive Therapy (MBCT) was developed specifically to treat depression and has been found to reduce depression alone or in combination with anti-depressive drugs.  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate depression. Hence, it is reasonable to study the effects of MBCT on patients who suffer with chronic physical disease and comorbid depression.

 

In today’s Research News article “Group and Individual Mindfulness-Based Cognitive Therapy (MBCT) Are Both Effective: a Pilot Randomized Controlled Trial in Depressed People with a Somatic Disease.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1479247762099145/?type=3&theater

or see summary below or view the full text of the study at:

http://link.springer.com/article/10.1007/s12671-016-0575-z

Schroevers and colleagues recruited adults, 18 to 70 years of age who have been diagnosed with a chronic physical disease and comorbid depression. They were randomly assigned to receive 8-weeks, 60-minutes, once a week, with home practice, of Mindfulness-Based Cognitive Therapy (MBCT) administered either individually or in a group of 8-12 patients. Before and after treatment and 3-months later the patients completed measures of depression, anxiety, positive well-being, mindfulness, and self-compassion.

 

They found that, regardless of whether MBCT was administered individually or in a group format, produced clinically significant improvements in depression, anxiety, positive well-being, mindfulness, and self-compassion. The sizes of the effects were large and they were maintained at 3-month follow-up. These results are encouraging and extend the range of applications of MBCT for depression to those who are depressed due to a chronic physical condition. They also suggest that using the much more efficient and cost effective group treatment method does not produce any reduction in benefits.

 

It should be mentioned that there was no control condition. So, the results have to be interpreted cautiously. Nevertheless, these kinds of effects have been demonstrated previously with randomized controlled clinical trials with depressed patients. These have demonstrated effectiveness reducing depression, and anxiety, and increasing positive well-being, mindfulness, and self-compassion So, it would seem reasonable to conclude that the effects observed with patients with chronic physical disease and comorbid depression were due to MBCT treatment and not a confounding factor.

 

So, if you feel depressed about a disease, try mindfulness.

 

“Most of us have issues that we find hard to let go and mindfulness can help us deal with them more productively. We can ask: ‘Is trying to solve this by brooding about it helpful, or am I just getting caught up in my thoughts?’ Awareness of this kind also helps us notice signs of stress or anxiety earlier and helps us deal with them better.” – Mark Williams

 

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 Twitter @MindfulResearch

 

Study Summary

Schroevers, M.J., Tovote, K.A., Snippe, E. et al. Group and Individual Mindfulness-Based Cognitive Therapy (MBCT) Are Both Effective: a Pilot Randomized Controlled Trial in Depressed People with a Somatic Disease. Mindfulness (2016) 7: 1339. doi:10.1007/s12671-016-0575-z

 

Abstract

Depressive symptoms are commonly reported by individuals suffering from a chronic medical condition. Mindfulness-based cognitive therapy (MBCT) has been shown to be an effective psychological intervention for reducing depressive symptoms in a range of populations. MBCT is traditionally given in a group format. The aim of the current pilot RCT was to examine the effects of group-based MBCT and individually based MBCT for reducing depressive symptoms in adults suffering from one or more somatic diseases. In this study, 56 people with a somatic condition and comorbid depressive symptoms (i.e., Beck Depression Inventory-II [BDI-II] ≥14) were randomized to group MBCT (n = 28) or individual MBCT (n = 28). Patients filled out questionnaires at three points in time (i.e., pre-intervention, post-intervention, 3 months follow-up). Primary outcome measure was severity of depressive symptoms. Anxiety and positive well-being as well as mindfulness and self-compassion were also assessed. We found significant improvements in all outcomes in those receiving group or individual MBCT, with no significant differences between the two conditions regarding these improvements. Although preliminary (given the pilot nature and lack of control group), results suggest that both group MBCT and individual MBCT are associated with improvements in psychological well-being and enhanced skills of mindfulness and self-compassion in individuals with a chronic somatic condition and comorbid depressive symptoms. Our findings merit future non-inferiority trials in larger samples to be able to draw more firm conclusions about the effectiveness of both formats of MBCT.

http://link.springer.com/article/10.1007/s12671-016-0575-z

Control Your Emotions with Mindfulness

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Control Your Emotions with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Feelings are often labelled as positive (happy, confident, joyful, brave, etc) or negative (sad, scared, hurt, angry etc). In mindfulness practice, feelings are not good or bad; they just are what they are – emotions that might be comfortable or uncomfortable, easy or difficult.” – Living Well

 

Mindfulness practice has been shown to produce improved emotion regulation. Practitioners demonstrate the ability to fully sense and experience emotions, but respond to them in more appropriate and adaptive ways. In other words, mindful people are better able to experience yet control emotions. This is a very important consequence of mindfulness. Humans are very emotional creatures and these emotions can be very pleasant, providing the spice of life. But, when they get extreme they can produce misery and even mental illness. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders.

 

There is a widespread problem in the west that many people don’t seem to like themselves. The self-dislike sometimes means that the individual dislikes every aspect of themselves; but most frequently people only don’t like certain aspects of themselves. Often it is there physical appearance, their school achievement, their career, their social behavior, etc. Making matters worse, they tend to overlook their strengths and discount them, focusing instead in the parts that they find problematic. This self-dislike is characteristic of depression. The antidote to self-dislike is self-compassion. Self-compassion is “treating oneself with kindness and understanding when facing suffering, seeing one’s failures as part of the human condition, and having a balanced awareness of painful thoughts and emotions” – Kristin Neff. Self-compassion has been demonstrated to be associated with better mental health.

 

Mindfulness and self-compassion are highly related and both are associated with better physical and mental health. But, it is not known which or both may be responsible for the benefits. In today’s Research News article “Mindfulness and Self-compassion as Unique and Common Predictors of Affect in the General Population.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1477031045654150/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107192/

López and colleagues examine the relative effectiveness of mindfulness and self-compassion to influence depression and both positive and negative emotions. They recruited a large representative national sample (the Netherlands), aged 20 to 96. They completed scales measuring five aspects of mindfulness, observe, describe, act with awareness, non-judgement and non-reactivity; two aspects of self-compassion, positive self-compassion (i.e., self-kindness, common humanity, and mindfulness) and negative self-compassion (i.e., self-judgment, isolation and over-identification); depression; and positive and negative emotions. They then applied a sophisticated statistical technique, multiple regression analysis, to explore which aspects of mindfulness and self-compassion predicted depression and emotions.

 

They found that the higher the levels of the mindfulness facets of act with awareness and non-judgement and the lower the levels of negative self-compassion, the lower the levels of depression and negative emotions, while the higher the levels the mindfulness facets of describe and non-reactivity and positive self-compassion, the higher the levels of positive emotions. When the combined effects of mindfulness and self-compassion were looked at, they equally predicted depression and negative emotions, but only mindfulness predicted positive emotions.

 

These are interesting results that suggest that mindfulness is associated with lower depression and negative emotions and higher positive emotions, in other words, improved mood and mental health. On the other hand, the results suggest that a harsh negative view of oneself (negative self-compassion) contributes to depression and negative feelings. An inference from these results is that improving mindfulness and self-like may importantly contribute to the mood and mental health of the general population. It remains for future research to determine if actively training mindfulness and self-liking will have these benefits.

 

So, control your emotions with mindfulness.

 

“The skills involved in emotion regulation may be fostered by becoming aware of emotions and by learning how to manage them without pushing them away or getting tangled up in them. Emotions are not static. Therefore, to train in the skills of emotion awareness, identification, and management, it is useful to practice noticing them “on the spot.” Mindfulness is the practice of purposeful attention without judgment. Mindfulness meditation is simply the practice of being aware of present-moment experience without trying to push it away or over-engage. Mindfulness helps train the mind to pay attention and notice, so that action can be taken with greater reflection.” – Learning to Breathe

 

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 Twitter @MindfulResearch

 

Study Summary

López, A., Sanderman, R., & Schroevers, M. J. (2016). Mindfulness and Self-compassion as Unique and Common Predictors of Affect in the General Population. Mindfulness, 7(6), 1289–1296. http://doi.org/10.1007/s12671-016-0568-y

 

Abstract

In contrast to the increased research interest in the benefits of mindfulness and self-compassion, relatively few studies have examined their unique and combined effects in predicting affect. This cross-sectional study examined the predictive value of mindfulness and self-compassion for depressive symptoms, negative affect, and positive affect in a large representative sample of community adults (N = 1736). The Five Facets of Mindfulness Questionnaire (FFMQ) was used as a measure of mindfulness and the Self-Compassion Scale (SCS) as a measure of self-compassion. Five FFMQ facets were explored: observe, describe, act with awareness, non-judgment, and non-reactivity. Two SCS facets were explored: its positive items (SCS Pos) and its negative items (SCS Neg). When simultaneously examining all seven facets of mindfulness and self-compassion, three of the five FFMQ facets and SCS Neg significantly predicted both depressive symptoms and negative affect, with SCS Neg and act with awareness being the strongest predictors. These findings suggest that a harsh attitude towards oneself and a lack of attention when acting have the greatest value in predicting the presence of psychological symptoms. With respect to positive affect, four of the five FFMQ facets (except non-judgment) were significant predictors, with no unique predictive value of the two SCS’s facets, suggesting that mindfulness is a more important predictor of positive affect than self-compassion, as measured by the FFMQ and SCS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107192/

 

Improve Neural Regulation of Negative Emotions with Mindfulness

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Improve Neural Regulation of Negative Emotions with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation might help depression, stress and anxiety but it’s not a ‘positive thinking’ tool that pretends everything is fine when it isn’t. It’s a way of being able to be with things as they are, in pain or in grief. It’s a way of being able to experience those inevitable parts of life, without your brain running away with its thoughts and making things worse, or pushing them away and resisting them.  It’s a way of being happy when we are happy, and to be fully present with our happiness, without holding onto that feeling too tightly because we fear the alternative.  And that’s where true peace lives.” – Ruth Rosselson

 

We’re very emotional creatures. Without emotion, life is flat and uninteresting. They are so important to us that they affect mostly everything that we do and say and can even be determinants of life or death. Anger, fear, and hate can lead to murderous consequences. Anxiety and depression can lead to suicide. At the same time love, joy, and happiness can make life worth living. Our emotions also affect us physically with positive emotions associated with health, well-being, and longevity and negative emotions associated with stress, disease, and shorter life spans.

 

There is a prevalent popular notion that to effectively deal with negative emotions such as grief and sadness, they have to be fully expressed and experienced. This is in general true as repression of powerful emotions can have long-term negative consequences. But, overexpressing emotions such that they become a focus of worry and rumination also has negative consequences. So, the key to dealing with powerful negative emotions is the middle way, to allow their expression, but then letting them go and moving on. A method to enhance this middle way is mindfulness. It has been shown to improve emotion regulation. People either spontaneously high in mindfulness or trained in mindfulness are better able to be completely in touch with their emotions and feel them completely, while being able to respond to them more appropriately and adaptively. In other words, mindful people are better able to experience yet control emotions. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health.

 

Mindfulness appears to act on emotions by producing relatively permanent changes to the nervous system, increasing the activity, size, and connectivity of some structures while decreasing it for others in a process known as neuroplasticity. So, mindfulness practice appears to affect emotion regulation by producing neuroplastic changes to the structures of the nervous system that underlie emotion. In today’s Research News article “Minding One’s Emotions: Mindfulness Training Alters the Neural Expression of Sadness.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1456402104383711/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017873/

Farb and colleagues investigate the nervous system’s response to a negative emotion, sadness, in people trained in mindfulness. They recruited participants and randomly assigned them to either receive an 8-week Mindfulness-Based Stress Reduction (MBSR) program or to a wait-list control group. Before and after training the participants were measured for anxiety, depression, and symptoms of psychopathology. Following training the participants had sadness induced by having them watch 3-min film clips from sad vs. neutral movies. They watched the movies while their brains were scanned with functional Magnetic Resonance Imaging (f-MRI).

 

They found that MBSR produced significant decreases in anxiety, depression, and in symptoms of psychopathology that were not apparent in the wait-list control group. Watching the sad movie clips, the sadness induction, produced a significant increase in sadness and in the activity in the brain structures associated with the Default Mode Network (DMN) that normally gets activated by self-reflective and ruminating thinking. Significantly, they found that the group who received MBSR training had a significantly lower neural response in the DMN to the sadness induction. This occurred in spite of the fact that the sadness induction produced equivalent increases in sadness in both groups. At the same time, the MBSR group showed a greater activation of the visceral and somatosensory areas of the cortex.

 

These findings suggest that mindfulness training improves mental health by altering the neural response to negative emotional states, in this case sadness. The fact that the responses of the visceral and somatosensory areas were heightened in the mindfulness trained participants suggests that they felt the emotional state more deeply. At the same time, the reduced activation of the Default Mode Network (DMN) in the mindfulness trained participants suggests that sadness produced less self-reflection, worry, and rumination. This suggests that the brain better regulates the response to the emotions after mindfulness training. Hence the finding suggest that mindfulness training improves the brain’s emotion regulation processes and thereby reduces anxiety, depression and the symptoms of psychopathology.

 

So, improve neural regulation of negative emotions with mindfulness.

 

“When I despair, I remember that all through history the way of truth and love have always won. There have been tyrants and murderers, and for a time, they can seem invincible, but in the end, they always fall. Think of it – always.”- Mahatma Gandhi

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Farb, N. A. S., Anderson, A. K., Mayberg, H., Bean, J., McKeon, D., & Segal, Z. V. (2010). Minding One’s Emotions: Mindfulness Training Alters the Neural Expression of Sadness. Emotion (Washington, D.C.), 10(1), 25–33. http://doi.org/10.1037/a0017151

 

Abstract

Recovery from emotional challenge and increased tolerance of negative affect are both hallmarks of mental health. Mindfulness training (MT) has been shown to facilitate these outcomes, yet little is known about its mechanisms of action. The present study employed functional MRI (fMRI) to compare neural reactivity to sadness provocation in participants completing 8 weeks of MT and waitlisted controls. Sadness resulted in widespread recruitment of regions associated with self-referential processes along the cortical midline. Despite equivalent self-reported sadness, MT participants demonstrated a distinct neural response, with greater right-lateralized recruitment, including visceral and somatosensory areas associated with body sensation. The greater somatic recruitment observed in the MT group during evoked sadness was associated with decreased depression scores. Restoring balance between affective and sensory neural networks—supporting conceptual and body based representations of emotion— could be one path through which mindfulness reduces vulnerability to dysphoric reactivity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017873/