Improve the Brain for Better memory in Aging with Yoga

September 28, 2016 psyjdc 1 Comment

By John M. de Castro, Ph.D.

“Yoga has been shown to reverse the aging process by the positive impact the practice has upon the body. It gives elasticity to your muscles, tones tendons and ligaments, reduces fat and slows weight gain, calms your heart rate, and eases your mind promoting a bodily as well as a spiritual peace.” – Amy Koller

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decreases during aging. 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. Using modern neuroimaging techniques, scientists have been able to view the changes that occur in the nervous system with aging. In addition, they have been able to investigate various techniques that might slow the process of neurodegeneration that accompanies normal aging. They’ve found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners.

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.

Since the global population of the elderly is increasing at unprecedented rates, it is imperative to investigate methods to slow physical and mental aging and mitigate its effects. It would seem reasonable to hypothesize that yoga practice, which is both a mindfulness practice and a physical exercise, might decrease age related cognitive decline and the associated changes in the nervous system. In today’s Research News article “Changes in Neural Connectivity and Memory Following a Yoga Intervention for Older Adults: A Pilot Study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1335144686509454/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927889/

Eyre and colleagues recruited elderly, over 55 years of age, and randomly assigned them to either 12-weeks of yoga training or 12-weeks of memory enhancement training. Depression levels, and memory ability were assessed at baseline and at 12-weeks after the interventions. In addition, the participants’ brains were scanned before and after training with Functional Magnetic Imaging (f-MRI) to ascertain the connectivity of various brain systems.

They found that the yoga group had significant improvements in depression and visuospatial memory. But, there were no significant differences between the yoga and memory enhancement training groups. They also investigated the relationships of the memory changes with changes in connectivity within the brain’s Default Mode Network (DMN) and found that the greater the increases in connectivity, the greater the improvements in memory in the elderly. The Default Mode Network (DMN) is known to be involved in memory, in particular in episodic memory retrieval, prospective memory encoding, and autobiographical memory retrieval. So, it makes sense that its connectivity would be increased in parallel to memory enhancements.

These results suggest that both yoga and memory enhancement training improve the interactions (connectivity) between structures of the brain that are involved in memory processing and that this results in improved memory ability in the elderly. It is interesting that yoga increased DMN connectivity in this study as contemplative practices have been shown to decrease the size and activity of the DMN. This suggests that yoga practice either may act differently or that just the memory components of the DMN are enhanced. It will take further research to clarify this.

The present results make it clear that yoga practice helps to slow the cognitive decline that occurs with aging. But, yoga is known to have a myriad of other physical, psychological, and physical benefits. It appears to be an excellent practice to allow for healthy aging. So, improve the brain for better memory in aging with yoga.

CMCS – Center for Mindfulness and Contemplative Studies

“It is a known fact that yoga imparts more energy, strength and flexibility. Some people turn to yoga for a reduction in stress, and then stick with it because it makes them feel, look, and remain young. Unlike traditional exercises, yoga blends moves that enhance circulation, flexibility, balance and strength, along with meditative techniques, including deep breathing. In fact, Yoga serves as a natural face-lift-it cleanes, relaxes, and restores. Yoga reduces signs of ageing considerably.” – Larry Payne

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

Study Summary

Eyre, H. A., Acevedo, B., Yang, H., Siddarth, P., Van Dyk, K., Ercoli, L., … Lavretsky, H. (2016). Changes in Neural Connectivity and Memory Following a Yoga Intervention for Older Adults: A Pilot Study. Journal of Alzheimer’s Disease, 52(2), 673–684. http://doi.org/10.3233/JAD-150653

Abstract

Background: No study has explored the effect of yoga on cognitive decline and resting-state functional connectivity.

Objectives: This study explored the relationship between performance on memory tests and resting-state functional connectivity before and after a yoga intervention versus active control for subjects with mild cognitive impairment (MCI).

Methods: Participants ( ≥ 55 y) with MCI were randomized to receive a yoga intervention or active “gold-standard” control (i.e., memory enhancement training (MET)) for 12 weeks. Resting-state functional magnetic resonance imaging was used to map correlations between brain networks and memory performance changes over time. Default mode networks (DMN), language and superior parietal networks were chosen as networks of interest to analyze the association with changes in verbal and visuospatial memory performance.

Results: Fourteen yoga and 11 MET participants completed the study. The yoga group demonstrated a statistically significant improvement in depression and visuospatial memory. We observed improved verbal memory performance correlated with increased connectivity between the DMN and frontal medial cortex, pregenual anterior cingulate cortex, right middle frontal cortex, posterior cingulate cortex, and left lateral occipital cortex. Improved verbal memory performance positively correlated with increased connectivity between the language processing network and the left inferior frontal gyrus. Improved visuospatial memory performance correlated inversely with connectivity between the superior parietal network and the medial parietal cortex.

Conclusion: Yoga may be as effective as MET in improving functional connectivity in relation to verbal memory performance. These findings should be confirmed in larger prospective studies.

Keywords: Aging, cognitive decline, memory training, mild cognitive impairment, mind-body, older adults, subjective memory complaints, yoga

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927889/

Be a Better Parent with Self-Compassion

September 24, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Parental depression negatively affects fathers’ and mothers’ caregiving, material support, and nurturance, and is associated with poor health and developmental outcomes for children of all ages, including prenatally. Depressed mothers are more likely than non-depressed mothers to have poor parenting skills and to have negative interactions with their children.” – Child Trends

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, suicide attempts or suicide. Needless to say individuals with depression are miserable.

Depression does not occur in isolation. When an individual in a family is depressed it affects all of the members of the family. When it is a parent, it affects how the child is raised and what he/she experiences during the formative years. This can have long-lasting effects on the child. So, it is important to study how depression affects childrearing and the child and what are the factors that might mitigate or eliminate the effects of parental depression on the child.

A characteristic of western society is that many people don’t seem to like themselves. The term used to describe this that I prefer is self-dislike. This is often highly associated with depression. Its opposite is self-compassion; being kind and understanding toward yourself in the face of inadequacies or short-comings. So, it would make sense to investigate the relationship of self-compassion with depression and child rearing. In today’s Research News article “Self-Compassion and Parenting in Mothers and Fathers with Depression.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1331610153529574/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923280/

Psychogiou and colleagues do just that. They recruited parents of young children (2-6 years of age) who were also suffering with depression. They measured them for depression, self-compassion, parental emotions, children’s internalizing and externalizing, and parental coping with children’s negative emotions.

They found that for both mothers and fathers, low levels of depression were significantly associated with high levels of self-compassion. Parenting ability was also associated with self-compassion, with mother who were high in self-compassion expressing fewer critical comments and more positive comments toward their children. In addition, parents who were high in self-compassion had fewer distressed reactions to their children’s behavior. High parental self-compassion was also significantly associated with the children having low internalizing and externalizing symptoms. Hence, depressed parents who have high levels of self-compassion are less critical of their children, responded better to their children’s behaviors, and produced less self-blame (internalizing) in their children.

These findings suggest that self-compassion may be to some extent an antidote to depression and to mitigate the effects of that depression on parenting. It would appear that if the parent is kind and understanding toward themselves it reduces their depression level and the kindness and understanding appears to transfer to their children producing more positive and productive parenting behaviors. But, the interpretation of these findings must be tempered as the results are correlational and as such do not demonstrate causation. Future studies should attempt to manipulate self-compassion and determine the effects of increasing it on depression and parenting. Since, mindfulness practices are known to increase self-compassion and improve caregiving and parenting, it would make sense to apply mindfulness training to depressed parents and observe its effects.

So, be a better parent with self-compassion.

“We are all used to working on our self-esteem by asking ourselves, “Am I being a good parent or a bad parent?” The problem is that having high self-esteem is contingent upon experiencing success. If we don’t meet our own standards, we feel terrible about ourselves. Self-compassion, in contrast, is not a way of judging ourselves positively or negatively. It is a way of relating to ourselves kindly and embracing ourselves as we are, flaws and all.” – Kristin Neff

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

Psychogiou, L., Legge, K., Parry, E., Mann, J., Nath, S., Ford, T., & Kuyken, W. (2016). Self-Compassion and Parenting in Mothers and Fathers with Depression. Mindfulness, 7, 896–908. http://doi.org/10.1007/s12671-016-0528-6

Abstract

Depression in parents impairs parenting and increases the risk of psychopathology among their children. Prevention and intervention could be informed by knowledge of the mechanisms that break the inter-generational transmission of psychopathology and build resilience in both parents and their children. We used data from two independent studies to examine whether higher levels of self-compassion were associated with better parenting and fewer emotional and behavioral problems in children of parents with a history of depression. Study 1 was a pilot trial of mindfulness-based cognitive therapy that included 38 parents with recurrent depression. Study 2 was a longitudinal study that consisted of 160 families, including 50 mothers and 40 fathers who had a history of depression. Families were followed up approximately 16 months after the first assessment (time 2; n = 106 families). In both studies, self-compassion was assessed with the Self-Compassion Scale. Parents reporting higher levels of self-compassion were more likely to attribute the cause of their children’s behavior to external factors, were less critical, and used fewer distressed reactions to cope with their children’s emotions. Parents’ self-compassion was longitudinally associated with children’s internalizing and externalizing problems, but these associations became nonsignificant after controlling for child gender, parent education, and depressive symptoms. Future larger scale and experimental designs need to examine whether interventions intended to increase self-compassion might reduce the use of negative parenting strategies and thereby the inter-generational transmission of psychopathology.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923280/

Mindfulness Training Equals Drugs in Effectiveness for Depression

September 8, 2016 psyjdc Leave a comment

Mindfulness Training Equals Drugs in Effectiveness for Depression

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 distinguishable from everyday sadness or grief by the depth, intensity, and range of symptoms. These can include feelings of sadness, tearfulness, emptiness or hopelessness, worthlessness , angry outbursts, irritability or frustration, even over small matters, loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports, sleep disturbances, tiredness and lack of energy, so even small tasks take extra effort, changes in appetite, anxiety, agitation or restlessness, slowed thinking, suicidal thoughts, and suicide attempts or suicide. Needless to say individuals with depression are miserable.

Depression is generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression. Depression appears to be the result of a change in the nervous system that is primarily treated with drugs that alter the affected neurochemical systems. But, depression can be difficult to treat. 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 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 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. The combination of drugs along with MBCT has been shown to be quite effective in treating depression and preventing relapse. Since, drugs have troubling side effects and can lose effectiveness over time, it is important to determine if after remission, MBCT can continue to prevent relapse if the drugs are removed. In other words, after MBCT can the drugs be withdrawn.

In today’s Research News article “The effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse/recurrence: results of a randomised controlled trial (the PREVENT study).” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1317432901613966/?type=3&theater

or see summary below or view the full text of the study at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781448/ Kuyken and colleagues randomly assigned patients with major depression who are taking antidepressant medications to either continue their medication or taper off the drugs and receive Mindfulness Based Cognitive Therapy (MBCT). Patients were followed for two years. They found that MBCT was as effective as continuing drugs in preventing reoccurrence of the depression, and reducing the number of depression free days, symptoms of depression, quality of life, and other psychological problems. Hence, MBCT was found to be a safe and effective alternative to continued drug treatment.

These results are striking. Mindfulness Based Cognitive Therapy (MBCT) can be used to replace drugs. It is not superior, but it appears to be equal to drug treatments in relieving depression and preventing its reoccurrence. The fact that its benefits were still present two years later indicates that MBCT produces lasting effects. Since MBCT does not have the troubling side effects that typically accompany the drugs, it may be a superior treatment. So, MBCT should be strongly considered to replace antidepressant drugs in the treatment of recurrent major depression

“Mindfulness is a valuable practice for improving the cognitive symptoms of depression, such as distorted thinking and distractibility. It helps individuals recognize these more subtle symptoms, realize that thoughts are not facts and refocus their attention to the present.” –

Margarita Tartakovsky

CMCS – Center for Mindfulness and Contemplative Studies

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

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

Study Summary

Kuyken, W., Hayes, R., Barrett, B., Byng, R., Dalgleish, T., Kessler, D., … Byford, S. (2015). The effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse/recurrence: results of a randomised controlled trial (the PREVENT study). Health Technology Assessment (Winchester, England), 19(73), 1–124. http://doi.org/10.3310/hta19730

Abstract

BACKGROUND: Individuals with a history of recurrent depression have a high risk of repeated depressive relapse/recurrence. Maintenance antidepressant medication (m-ADM) for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to m-ADM. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce the risk of relapse/recurrence compared with usual care but has not yet been compared with m-ADM in a definitive trial.

OBJECTIVES: To establish whether MBCT with support to taper and/or discontinue antidepressant medication (MBCT-TS) is superior to and more cost-effective than an approach of m-ADM in a primary care setting for patients with a history of recurrent depression followed up over a 2-year period in terms of preventing depressive relapse/recurrence. Secondary aims examined MBCT’s acceptability and mechanism of action.

DESIGN: Single-blind, parallel, individual randomised controlled trial.

SETTING: UK general practices.

PARTICIPANTS: Adult patients with a diagnosis of recurrent depression and who were taking m-ADM.

INTERVENTIONS: Participants were randomised to MBCT-TS or m-ADM with stratification by centre and symptomatic status. Outcome data were collected blind to treatment allocation and the primary analysis was based on the principle of intention to treat. Process studies using quantitative and qualitative methods examined MBCT’s acceptability and mechanism of action.

MAIN OUTCOMES MEASURES: The primary outcome measure was time to relapse/recurrence of depression. At each follow-up the following secondary outcomes were recorded: number of depression-free days, residual depressive symptoms, quality of life, health-related quality of life and psychiatric and medical comorbidities.

RESULTS: In total, 212 patients were randomised to MBCT-TS and 212 to m-ADM. The primary analysis did not find any evidence that MBCT-TS was superior to m-ADM in terms of the primary outcome of time to depressive relapse/recurrence over 24 months [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.67 to 1.18] or for any of the secondary outcomes. Cost-effectiveness analysis did not support the hypothesis that MBCT-TS is more cost-effective than m-ADM in terms of either relapse/recurrence or quality-adjusted life-years. In planned subgroup analyses, a significant interaction was found between treatment group and reported childhood abuse (HR 1.89, 95% CI 1.06 to 3.38), with delayed time to relapse/recurrence for MBCT-TS participants with a more abusive childhood compared with those with a less abusive history. Although changes in mindfulness were specific to MBCT (and not m-ADM), they did not predict outcome in terms of relapse/recurrence at 24 months. In terms of acceptability, the qualitative analyses suggest that many people have views about (dis)/continuing their ADM, which can serve as a facilitator or a barrier to taking part in a trial that requires either continuation for 2 years or discontinuation.

CONCLUSIONS: There is no support for the hypothesis that MBCT-TS is superior to m-ADM in preventing depressive relapse/recurrence among individuals at risk for depressive relapse/recurrence. Both treatments appear to confer protection against relapse/recurrence. There is an indication that MBCT may be most indicated for individuals at greatest risk of relapse/recurrence. It is important to characterise those most at risk and carefully establish if and why MBCT may be most indicated for this group.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781448/

Detach from Depression with Mindfulness

September 1, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

Depression is epidemic. Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year. It also affects children with one in 33 children and one in eight adolescents having clinical depression. It is so serious that it can be fatal as about 2/3 of suicides are caused by depression. It makes lives miserable, not only the patients but also associates and loved ones, interferes with the conduct of normal everyday activities, and can come back repeatedly. Even after complete remission, 42% have a reoccurrence.

Depression appears to be the result of a change in the nervous system that can generally only be reached with drugs that alter the affected neurochemical systems. But, of the patients treated initially with drugs only about a third attain remission and even after repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attain remission. In addition, the drugs can lose effectiveness over time and can have problematic side effects, So, it is important that other safe and effective treatments be identified.

Depression has also been long hypothesized to have roots in early childhood. Patterns of mother-child interactions are thought to produce different forms of attachment styles in the infant, including secure, insecure, avoidant, ambivalent, fearful, preoccupied, and disorganized attachment styles. All of these styles, save secure attachment style, have been found to be associated with depression.

Mindfulness training has been shown to be effective for depression alone or in combination with drug therapy. One way that mindfulness may effect depression is by altering the effects of attachment style on depression. In today’s Research News article “Mediating Role of Mindfulness as a Trait Between Attachment Styles and Depressive Symptoms.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1310795515611038/?type=3&theater

or see summary below. Linares and colleagues investigate this hypothesis. They recruited over 500 adults and measured depression, emotional distress, mindfulness, decentering and attachment styles and statistically investigate the interrelationships between these variables.

They found that high levels of depression were associated with low mindfulness, decentering, and secure attachment styles and with high levels of anxiety and preoccupied and fearful attachment styles. The preoccupied and fearful attachment styles had primarily direct influences with depression. There were small but significant mediation effects for the non-judging facet of mindfulness and for decentering.

These results suggest that attachment styles do indeed affect depression, but mainly do so directly. Non-judging mindfulness and decentering are affected by attachment styles but only have a small effect on the attachment style effects on depression. As has been demonstrated repeatedly in the research literature, mindfulness reduces depression and attachment styles can increase depression, but appear to do so relatively independently. Since they seem to act on depression relatively independently, it may be reasonable to test the combination of mindfulness treatment and treatment for attachment styles for the relief of depression.

So, detach from depression with mindfulness.

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

Linares L, Jauregui P, Herrero-Fernández D, Estévez A. Mediating Role of Mindfulness as a Trait Between Attachment Styles and Depressive Symptoms. J Psychol. 2016 Jul 28:1-16. [Epub ahead of print] DOI: 10.1080/00223980.2016.1207591

Abstract

Attachment styles and dysfunctional symptoms have been associated. This relationship could be affected by metacognitive capacity. The aim of this study is to clarify the relationship between depressive symptoms, attachment styles, and metacognitive capacity. In addition, the mediating role of metacognition between attachment and depressive symptoms has been studied. A total of 505 participants recruited from the general population of the province of Bizkaia (Spain) completed questionnaires regarding depression, anxiety, mindfulness, decentering, and attachment. Results showed positive and significant relations between (a) dysfunctional symptoms and insecure attachment styles and (b) metacognitive capacity and secure attachment style. Additionally, the mediating role of metacognition between attachment and depressive symptoms was confirmed. Intervention in metacognitive abilities such as mindfulness could be a useful therapeutic tool for depressive symptoms.

Reduce Depression and PTSD Symptoms in Caregivers for Dying Children with Mindfulness

August 30, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Mindfulness Self-Compassion turns the usual self-critical paradigm around and asks the care partner, in the midst of a difficult caregiving moment; become aware of the emotions that arise in the moment and where they reside in your body (Mindfulness), recognize that there are others who suffer in this way (Common Humanity), and then offer yourself what you need in the moment (Self-Kindness). Again, this is not to change the moment of suffering for the person you are caring for or for yourself, but because you are suffering too! In the end this supports both of you in a softer way and provides the circumstances, not necessarily for ‘cure’ but for healing.” – Sarel Rowe

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. This is the fatigue, cynicism, and professional inefficacy that comes with work-related stress. Burnout is associated with depression-like symptoms and often post-traumatic stress disorder (PTSD)-like symptoms. Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout.

Providing care for the dying can be can be a very satisfying, rewarding, and even joyful experience. But, over time, caregiving can wear the caregiver out and can lead to burnout. Indeed, 62% of physicians involved with end of life care report symptoms of burnout. This is magnified many times when the patient is a child. This is supposed to be the beginning of life, not its end. It is often the case that caregivers for the dying become personally attached to their patient. With a child, that attachment becomes deep and profoundly emotional. This level of emotional stress is difficult to repeatedly endure. So, there is a need to find ways to help the healthcare professionals who provide care in general, but particularly for those working with children to cope with the stress and emotional drain.

It has recently been demonstrated that mindfulness training can help caregivers cope with the stress. It has also been shown to help to prevent burnout in multiple occupations and particularly in healthcare workers. So, it would make sense to investigate the effectiveness of mindfulness training in preventing burnout in healthcare workers providing end of life care to children. In today’s Research News article “Multimodal Mindfulness Training to Address Mental Health Symptoms in Providers Who Care for and Interact with Children in Relation to End-of-Life Care.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1308949565795633/?type=3&theater

or see summary below. O’Mahoney and colleagues recruited palliative care and other health-care professionals who were involved in caring for terminally ill children. They received a 9-week mindfulness training program meeting once a week for 2 hours in the evening. They were measured before and after training for experiential avoidance, cognitive fusion (taking thoughts as true and upsetting), depression, burnout, and PTSD symptoms.

They found that the mindfulness training resulted in significant decreases in depression and post-traumatic stress disorder (PTSD) symptoms. These are interesting preliminary results. But, there is a need to follow this up with a randomized controlled trial to determine unequivocally if the training was responsible for the improvements. The effects do seem reasonable as mindfulness training has been shown in different contexts to reduce depression and improve PTSD symptoms. These findings simply extend these general understandings of the effects of mindfulness training to end of life care for children. But, again demonstrate the usefulness of mindfulness training to relieve the psychological effects of caregiving.

So, reduce depression and PTSD symptoms in caregivers for dying children with mindfulness.

CMCS – Center for Mindfulness and Contemplative Studies

“We are set up for short-term stress, but caregiving is long-term stress. Mindfulness works to inhibit the stress response. Most of us run around listening to our thoughts, and this is particularly true of caregivers, who are driven by the To-Do list. They are never at rest.” – Griffiths Vega

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

Study Summary

O’Mahony S, Gerhart J, Abrams I, Greene M, McFadden R, Tamizuddin S, Levy MM. A Multimodal Mindfulness Training to Address Mental Health Symptoms in Providers Who Care for and Interact With Children in Relation to End-of-Life Care. Am J Hosp Palliat Care. 2016 Jul 21. pii: 1049909116660688. [Epub ahead of print]

Abstract

AIM: Medical providers may face unique emotional challenges when confronted with the suffering of chronically ill, dying, and bereaved children. This study assessed the preliminary outcomes of participation in a group-based multimodal mindfulness training pilot designed to reduce symptoms of burnout and mental health symptoms in providers who interact with children in the context of end-of-life care.

METHODS: A total of 13 medical providers who care for children facing life-threatening illness or bereaved children participated in a 9-session multimodal mindfulness session. Mental health symptoms and burnout were assessed prior to the program, at the program midpoint, and at the conclusion of the program.

RESULTS: Participation in the pilot was associated with significant reductions in depressive and posttraumatic stress disorder (PTSD) symptoms among providers (P < .05).

CONCLUSION: Mindfulness-based programs may help providers recognize and address symptoms of depression and PTSD. Additional research is needed to enhance access and uptake of programming among larger groups of participan

Improve Body Awareness and Reduce Depression Due to Pain with Mindfulness

August 29, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

We all have to deal with pain. It’s inevitable, but hopefully mild and short lived. But, for a wide swath of humanity pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. Chronic pain accompanies a number of conditions. The most common form of chronic pain is low back pain affecting between 6% to 15% of the population. Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. In the U.S., osteoarthritis affects 14% of adults over 25 years of age and 34% of those over 65. Fibromyalgia is a mysterious disorder whose causes are unknown. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. It is very common affecting over 5 million people in the U.S., about 2% of the population.

Pain involves both physical and psychological issues. Indeed, people with chronic pain are much more likely to become depressed and people with depression are much more likely to develop chronic pain. Mindfulness practices have been shown to be safe and beneficial in pain management and to reduce depression. But, how mindfulness training may reduce the depression accompanying chronic pain is not known. Mindfulness is known to improve the awareness of the sensations from the body. It is possible then that the reduction of depression about pain is produced by making the patient more aware of their bodies and thus better able to respond to any aversive states in the body.

In today’s Research News article “Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1308036735886916/?type=3&theater

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

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.00967/full

de Jong and colleagues recruited chronic pain patients with depression and randomly assigned them to receive either an 8-week Mindfulness-Based Cognitive Therapy (MBCT) plus the normal treatment provided to these patients or to receive only treatment as usual. They were measured for body awareness, pain catastrophizing, and depression before, during, and after the 8 weeks of treatment.

They found that the MBCT group had reduced depression and increased body awareness, especially in self-distracting and self-regulation. “Not-Distracting refers to not ignoring or distracting oneself from uncomfortable body sensations such as pain. Self-Regulation refers to the ability to control psychological distress by consciously attending to body sensations.” Hence MBCT significantly improved the chronic pain patient’s ability to control their pain by paying attention to it. Using a sophisticated statistical technique of mediation analysis, they were able to determine that the effects of mindfulness on depression were completely mediated by its effect on body awareness.

These results are interesting and important. It is well established that mindfulness training and MBCT in particular are very effective in reducing depression. The present findings, though, demonstrate that its ability to reduce the depression produced by chronic pain is due to improved body awareness. This may seem counterintuitive that increasing the awareness of body pain would improve the depression produced by the pain. But, denying pain by ignoring it or by distracting oneself from it doesn’t work and actually increases its pain’s impact by increasing worry and rumination. Directly addressing the pain and seeing it as it is, makes it easier to cope with it.

So, improve body awareness and reduce depression due to pain with mindfulness.

“MBCT helps participants learn how to recognize their sense of being and see themselves as separate from their thoughts and moods. This disconnect can allow people to become liberated from thought patterns in which the same negative messages may be replayed over and over. . . . In general, MBCT attempts to give participants the necessary tools to combat depressive symptoms as they arise. People who learn these skills may then be able to revert to these methods in times of distress or when faced with potentially overwhelming situations.” – Goodtherapy.org

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

de Jong M, Lazar SW, Hug K, Mehling WE, Hölzel BK, Sack AT, Peeters F, Ashih H, Mischoulon D and Gard T (2016) Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression. Front. Psychol. 7:967. doi: 10.3389/fpsyg.2016.00967

Abstract

Body awareness has been proposed as one of the major mechanisms of mindfulness interventions, and it has been shown that chronic pain and depression are associated with decreased levels of body awareness. We investigated the effect of Mindfulness-Based Cognitive Therapy (MBCT) on body awareness in patients with chronic pain and comorbid active depression compared to treatment as usual (TAU; N = 31). Body awareness was measured by a subset of the Multidimensional Assessment of Interoceptive Awareness (MAIA) scales deemed most relevant for the population. These included: Noticing, Not-Distracting, Attention Regulation, Emotional Awareness, and Self-Regulation. In addition, pain catastrophizing was measured by the Pain Catastrophizing Scale (PCS). These scales had adequate to high internal consistency in the current sample. Depression severity was measured by the Quick Inventory of Depressive Symptomatology-Clinician rated (QIDS-C16). Increases in the MBCT group were significantly greater than in the TAU group on the “Self-Regulation” and “Not Distracting” scales. Furthermore, the positive effect of MBCT on depression severity was mediated by “Not Distracting.” These findings provide preliminary evidence that a mindfulness-based intervention may increase facets of body awareness as assessed with the MAIA in a population of pain patients with depression. Furthermore, they are consistent with a long hypothesized mechanism for mindfulness and emphasize the clinical relevance of body awareness.

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.00967/full

Improve Anxiety and Depression in Primary Care with Mindfulness

August 20, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Group mindfulness treatment should be considered as an alternative to individual psychotherapy, especially at primary health care centers that can’t offer everyone individual therapy,” – Jan Sundquist

“Primary care is at the front line of the health delivery system” (Craner et al., 2016). Most patients enter the health system either though primary care physicians who are responsible for wellness and for the diagnosis and treatment of mental and physical diseases. If the disease is common or simple, they’ll treat it themselves or if it’s more complex or dangerous they’ll refer it to specialists. Either way, they’re the first step in treatment.

Mood and anxiety disorders, including depression are the most common mental illnesses and affect almost 30% of the US population. Depression is the most common mental disorders seen in primary care patients, constituting nearly a third of all patients. People with an anxiety disorder are 3 to 5 times more likely than those without to visit their doctor and constitute around 6% of primary care patients. Hence these mood disorders are an important challenge for primary care. Yet, primary care physicians have little training in psychological therapy techniques and generally treat these disorders by prescribing drugs.

In recent years, it has become apparent that mindfulness training is a powerful treatment option for depression and anxiety disorders either alone or in combination with other therapies. It is rare, however, for mindfulness training to be implemented in the course of primary care. In today’s Research News article “Outcomes of a 6-Week Cognitive– Behavioral and Mindfulness Group Intervention in Primary Care.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1300205500003373/?type=3&theater

or see summary below.

Craner and colleagues recruited patients who came into primary care with a diagnosis of either depression or anxiety disorders. They were provided 6-weeks of therapy that was a combination of mindfulness training and Cognitive Behavioral Therapy (CBT). Instruction was provided in weekly 1-hour group sessions and patients were encouraged to practice at home. They were measured for depression and anxiety disorder intensity before and after the conclusion of treatment.

They found that after the therapy the patients had a large and significant reduction in both their depression and anxiety. This was particularly significant in that these impressive results were obtained from a relatively brief group treatment delivered in the primary care facility itself. To our knowledge this is the first demonstration of successful mindfulness-based treatment for mood disorders conducted in a primary care facility. This is an ideal point for delivery of services to treat a major mental health problem in a safe and effective way without expensive specialist involvement and without employing drugs. Because the services were delivered at the point of entry into the health care system, it allows the delivery of services quickly, immediately upon diagnosis, maximizing effectiveness.

But, the results must be interpreted cautiously as there was no comparison or control condition. A randomized controlled clinical trial is needed to insure that the positive results were due the mindfulness-based therapy and not due to a placebo effect, experimenter bias, spontaneous remissions, or some other confounding factor. But, these are exciting preliminary findings which clearly support conducting further research.

CMCS – Center for Mindfulness and Contemplative Studies

“Once I stopped battling anxiety, it lost its power over me. The negative thoughts do still pop up, but what has changed is how I react to them now that they no longer frighten me. On the few occasions that I have had panic attacks since practicing mindfulness, I have consciously switched to mindful breathing and the panic has subsided. The vicious circle has gone, and has been replaced with positive thoughts about everything I have achieved and may yet achieve. I will always have anxious thoughts, I’m only human, but I know they are just that, just thoughts.” – Amy Straker

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

Study Summary

Craner, J. R., Sawchuk, C. N., & Smyth, K. T. (2016, July 14). Outcomes of a 6-Week Cognitive– Behavioral and Mindfulness Group Intervention in Primary Care. Families, Systems, & Health. Advance online publication. http://dx.doi.org/10.1037/fsh0000202

Abstract:

Introduction: Cognitive–behavioral and mindfulness-based interventions are established treatments for depressive and anxiety disorders; however, there is a lack of research for these interventions in primary care settings. The current study evaluates an evidence-based group intervention provided to primary care patients with a variety of mood and anxiety concerns. Method: Participants included 54 adult primary care patients who attended at least four sessions of a six-session cognitive–behavioral and mindfulness group. A total of nine separate groups were conducted, all of which were colocated within the primary care setting. Major depressive disorder and generalized anxiety disorder were the most common psychiatric conditions, with approximately 56% of the sample having one or more chronic medical conditions. Self-report measures of depression (Patient Health Questionnaire–9) and anxiety (Generalized Anxiety Disorder Questionnaire–7) were completed at each session. Results: Significant improvements were noted on self-reported measures of depression and anxiety when comparing pre- and posttreatment assessment measures with large effect sizes. Discussion: A brief, principle-based cognitive–behavioral and mindfulness group intervention delivered in primary care was associated with improved symptoms across a range of patient presentations. Evidence-based group interventions in primary care settings have the benefits of increased access and cost-effectiveness.

Use Mindfulness for Major Depression Rather than Drugs

August 13, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Many participants said that as time went on, the benefits of MBCT permeated their whole life. ‘Through relating mindfully to their own experiences and to others, they were feeling more confident and were engaging with an increased range of social activity and involvement’.” – Emily Nauman

Depression is epidemic. Major depressive disorder affects approximately 14.8 million American adults, or about 7% of the U.S. population age 18 and older. Depression is more prevalent in women than in men. It also affects children with one in 33 children and one in eight adolescents having clinical depression. It is so serious that it can be fatal as about 2/3 of suicides are associated with depression. It makes lives miserable, not only the patients but also associates and loved ones, interferes with the conduct of normal everyday activities, and can come back repeatedly. Even after complete remission, 42% have a reoccurrence.

The first line treatment is antidepressant drugs. But, depression can be difficult to treat. Of patients treated initially with drugs only about a third attained remission and even after repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attain remission. This leaves a third of all patients treated still in deep depression. Being depressed and not responding to treatment 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 meditation is a safe alternative that has been shown to be effective for major depressive disorder even in individuals who do not respond to drug treatment. Mindfulness Based Cognitive Therapy (MBCT) was developed specifically to treat depression and has been shown to be very effective in treating existing depression and preventing relapse when depression is in remission. 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 “A Preliminary Study: Efficacy of Mindfulness-Based Cognitive Therapy versus Sertraline as First-line Treatments for Major Depressive Disorder.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1294008510623072/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465797/

Eisendrath and colleagues tested the efficacy of 8-weeks of Mindfulness Based Cognitive Therapy (MBCT) alone vs. 8-weeks of an antidepressant drug (sertraline) alone for matched patients with Major Depressive Disorder. Patients were measured before and after treatment for depression, depressive symptoms, mindfulness, self-compassion, rumination, and decentering. They found that both MBCT and antidepressant drug treatments produced significant decreases in depressive symptoms. But the MBCT group showed significantly greater improvement. They also found that for the MBCT group, the greater the increase in mindfulness and decentering, the greater the improvement in depression.

These are excellent and important results. Mindfulness Based Cognitive Therapy (MBCT) as the sole treatment was more effective than an antidepressant drug in decreasing depressive symptoms in patients suffering from major depressive disorder. In addition, this greater improvement appeared to be due to increases in mindfulness. It is significant that MBCT is actually more effective than drugs. It remains to be seen if its effects continue, preventing relapse after the cessation of active treatment.

It is not known exactly how mindfulness relieves depression. It can be speculated that mindful meditation by shifting attention away from the past or future to the present moment interrupts the kinds of thinking that are characteristic of and support depression. These include rumination about past events, worry about future events, and catastrophizing about potential future events. Mindfulness meditation has been shown to interrupt rumination, worry, and catastrophizing and focus the individual on what is transpiring in the present. By interrupting these forms of thinking that support depression, shifting attention to the present moment where situations are actually manageable, mindful meditation may disrupt depression.

Regardless of the speculations, it is clear that MBCT is a safe and effective treatment for major depressive disorder. So, use mindfulness for major depression rather than drugs.

CMCS – Center for Mindfulness and Contemplative Studies

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Study Summary

Eisendrath, S. J., Gillung, E., Delucchi, K., Mathalon, D. H., Yang, T. T., Satre, D. D., … Wolkowitz, O. M. (2015). A Preliminary Study: Efficacy of Mindfulness-Based Cognitive Therapy versus Sertraline as First-line Treatments for Major Depressive Disorder. Mindfulness, 6(3), 475–482. http://doi.org/10.1007/s12671-014-0280-8

Abstract

Major depressive disorder (MDD) is the leading cause of disability in the developed world, yet broadly effective treatments remain elusive. The primary aim of this pilot study was to investigate the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) monotherapy, compared to sertraline monotherapy, for patients with acute MDD. This open-label, nonrandomized controlled trial examined a MBCT cohort (N=23) recruited to match the gender, age, and depression severity of a depressed control group (N=20) that completed 8 weeks of monotherapy with the antidepressant sertraline. The 17-item clinician-rated Hamilton Depression Severity Rating Scale (HAMD-17) was the primary outcome measure of depression to assess overall change after 8 weeks and rates of response and remission. The 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) was the secondary outcome measure to further assess depression severity. Both cohorts were demographically similar and showed significant improvement in depression ratings. No difference was found in the degree of change in HAMD-17 scores (t(34) = 1.42, p = .165) between groups. Secondary analysis showed statistically significant differences in mean scores of the QIDS-SR16 (t (32) = 4.39, p < 0.0001), with the MCBT group showing greater mean improvement. This study was limited by the small sample size and non-randomized, non-blinded design. Preliminary findings suggest that an 8-week course of MBCT monotherapy may be effective in treating MDD and a viable alternative to antidepressant medication. Greater changes in the self-rated QIDS-SR16 for the MBCT cohort raise the possibility that patients derive additional subjective benefit from enhanced self-efficacy skills.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465797/

Reduce Anxiety and Depression Among Patients with Cancer with Mindfulness

August 9, 2016 psyjdc 3 Comments

By John M. de Castro, Ph.D.

“Mindfulness meditation is known to have a positive emotional and psychological impact on cancer survivors. But some groundbreaking new research has found that meditation is also doing its work on the physical bodies of cancer survivors, with positive impacts extending down to the cellular level.” – Carolyn Gregoire

Receiving a diagnosis of cancer can have a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. But, cancer diagnosis is not a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly improving. It is estimated that 14,483,830 adults and children with a history of cancer alive in the United States today. So, there are a vast number of cancer survivors.

Surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day. Unfortunately, most of these residual problems go untreated. Psychologically, cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission.

Mindfulness training may be helpful for dealing with these psychological residual symptoms of cancer. It has been shown to improve recovery from cancer and to reduce anxiety and depression in people with a wide variety of conditions. In today’s Research News article “Effectiveness of Mindfulness-based Therapy for Reducing Anxiety and Depression in Patients with Cancer: A Meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1290482744308982/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912240/

Zhang and colleagues examine the published research literature investigating the effectiveness of mindfulness training for anxiety and depression in cancer patients. They report that the most common form of mindfulness training used in the published research for cancer were 8-week Mindfulness-Based Stress Reduction (MBSR) programs involving meditation, body scan and yoga practices. All studies examined contained a control condition, most commonly a treatment as usual wait-list group.

They found that the literature made a clear case that mindfulness based therapies produce significant improvements in both anxiety and depression in the cancer patients. Since mindfulness training involves training to focus on the present moment, it is easy to see how it could be effective against anxiety and depression. Anxiety involves fear of potential future problems while depression involves rumination about the past. The focus on what’s happening now, produced by mindfulness training, prevents thinking about the past producing depression and thinking about the future producing anxiety.

The findings in the research literature are important as depression causes great distress, impairs functioning, and might even make the person with cancer less able to follow their cancer treatment plan. In addition, high levels of anxiety are stressful, depleting the patient’s energy and reducing their ability to fight the cancer or other potential infections. Hence the ability of mindfulness training to reduce the depression and anxiety is important for not only the patients’ mental health but also for their physical ability to fight the cancer.

So, reduce anxiety and depression among patients with cancer with mindfulness.

“Cancer is not something that any of us would ever want to have happen to us, but it can be a tremendous opportunity to look at some of our conditioning. It can also be an opportunity to look deeply and make amends for some things we don’t like. We can come into a greater sense of peace with ourselves and with others.” – Elana Rosenbaum

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

Zhang, M.-F., Wen, Y.-S., Liu, W.-Y., Peng, L.-F., Wu, X.-D., & Liu, Q.-W. (2015). Effectiveness of Mindfulness-based Therapy for Reducing Anxiety and Depression in Patients with Cancer: A Meta-analysis. Medicine, 94(45), e0897. http://doi.org/10.1097/MD.0000000000000897

Abstract

Anxiety and depression are common among patients with cancer, and are often treated with psychological interventions including mindfulness-based therapy.

The aim of the study was to perform a meta-analysis of the effectiveness of mindfulness-based interventions for improving anxiety and depression in patients with cancer.

Medline, the Cochrane Library, EMBASE, and Google Scholar were searched. The randomized controlled trials designed for patients diagnosed with cancer were included. Mindfulness-based interventions were provided.

The outcomes assessed were the changes in anxiety and depression scores from before to after the intervention. The treatment response was determined by calculating the standardized mean difference (SMD) for individual studies and for pooled study results. Subgroup analyses by cancer type, type of therapy, and length of follow-up were performed.

Seven studies, involving 469 participants who received mindfulness-based interventions and 419 participants in a control group, were included in the meta-analysis. Mindfulness-based stress reduction and art therapy were the most common interventions (5/7 studies). All studies reported anxiety and depression scores. The pooled SMD of the change in anxiety significantly favored mindfulness-based therapy over control treatment (−0.75, 95% confidence interval −1.28, −0.22, P = 0.005). Likewise, the pooled SMD of the change in depression also significantly favored mindfulness-based therapy over control (−0.90, 95% confidence interval −1.53, −0.26, P = 0.006). During the length of follow-ups less than 12 weeks, mindfulness-based therapy significantly improved anxiety for follow-up ≤12 weeks after the start of therapy, but not >12 weeks after the start of therapy.

There was a lack of consistency between the studies in the type of mindfulness-based/control intervention implemented. Patients had different forms of cancer. Subgroup analyses included a relatively small number of studies and did not account for factors such as the severity of anxiety and/or depression, the time since diagnosis, and cancer stage.

Mindfulness-based interventions effectively relieved anxiety and depression among patients with cancer. However, additional research is still warranted to determine how long the beneficial effects of mindfulness-based therapy persist.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912240/

Get out of the Dumps with Yoga

July 25, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“One of the chapters in my life included a 10-year bout with deep depression. This depression became compounded when I was confronted with loss and grief. I took antidepressants of varying kinds for many years and attempted talk therapy. For me, none of these approaches worked. It was only when I began practicing yoga that I started to see and feel concrete, sustained shifts in my mental patterns, emotions, and internal state of being.” – Monique Minahan

Clinically diagnosed depression is the most common 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, suicide attempts or suicide. Needless to say individuals with depression are miserable.

Depression appears to be the result of a change in the nervous system that can generally only be reached with drugs that alter the affected neurochemical systems. But, depression can be difficult to treat. 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. In, addition, 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. So, it is important to investigate alternative treatments for depression.

There are some alternative activities that can be helpful for depression. Regular exercise can improve mood in people with mild to moderate depression. It also may play a supporting role in treating severe depression. Mindful meditation training including yoga practices have also been shown to be viable alternative treatments for depression. They have been shown to be an effective treatment for active depression and for the prevention of its recurrence. They can even be effective in cases where drugs fail. In addition, the combination of exercise with meditation has been shown to be effective for treating depression.

In today’s Research News article “Mindfulness-based yoga intervention for women with depression.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1278994708791119/?type=3&theater

or below, Schuver and Lewis investigate the relative effectiveness of yoga and walking exercise for the treatment of depression. They randomly assigned depressed women to either a 12-week mindfulness based yoga practice or walking exercise. Both treatments were practiced twice a week for 65 minutes for 12 weeks. Measurements of depression and rumination were taken before and after treatment and one-month after the completion of the 12-week practice period.

They found that both treatments produced significant decreases (34% and 38% respectively) in depression that were maintained at follow-up. Both groups also showed significant decreases in rumination but, the yoga group had a significantly greater decrease (30%) than the walking group (19%) at the end of treatment. But, by the one-month follow-up there were no significant differences between the groups. Hence, both treatments successfully improved depression and rumination in the depressed women.

So, it appears that exercise, regardless of whether it’s in the form of yoga or walking relieves depression. In practice, however, depressed people lack energy and it can be quite challenging for them to initiate or keep up an exercise practice. The current study employed a home yoga practice. It is possible that a yoga practice in a group would be more enjoyable and promote adherence to the exercise. More research is needed to investigate this conjecture.

Regardless it is clear that you can get out of the dumps with yoga.

“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.

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

Schuver KJ, Lewis BA. Mindfulness-based yoga intervention for women with depression. Complement Ther Med. 2016 Jun;26:85-91. doi: 10.1016/j.ctim.2016.03.003. Epub 2016 Mar 14.

Highlights

Efficacy of a 12-week yoga intervention, in comparison to a walking group, on mood and rumination among depressed women.
Participants in both groups demonstrated similar decreases in depressive symptoms from baseline to post-intervention.
The yoga condition reported significantly lower levels of rumination than the walking group at post-intervention.

Abstract

OBJECTIVES: The purpose of this study was to examine the efficacy of a 12-week mindfulness-based yoga intervention on depressive symptoms and rumination among depressed women.

DESIGN: Prospective, randomized, controlled 12 week intervention pilot study. Depressive symptoms were assessed at baseline, post-intervention (12 weeks), and one-month follow-up.

SETTING: Women with a history of diagnosed depression and currently depressed were randomized to a mindfulness-based yoga condition or a walking control.

INTERVENTIONS: The mindfulness-based yoga intervention consisted of a home-based yoga asana, pranayama and meditation practice with mindfulness education sessions delivered over the telephone. The walking control condition consisted of home-based walking sessions and health education sessions delivered over the phone.

MAIN OUTCOME MEASURES: The Beck Depression Inventory (BDI) and Ruminative Responses Scale (RRS).

RESULTS: Both groups reported decreases in depressive symptoms from baseline to post-intervention, f(1,33)=34.83, p<0.001, and from baseline to one-month follow-up, f(1,33)=37.01, p<0.001. After controlling for baseline, there were no significant between group differences on depression scores at post-intervention and the one-month follow-up assessment. The mindfulness-based yoga condition reported significantly lower levels of rumination than the control condition at post-intervention, after controlling for baseline levels of rumination, f(1,31)=6.23, p<0.01.

CONCLUSIONS: These findings suggest that mindfulness-based yoga may provide tools to manage ruminative thoughts among women with elevated depressive symptoms. Future studies, with larger samples are needed to address the effect of yoga on depression and further explore the impact on rumination.