Depression

Improve Well-Being with Menstrual Disorder with Yoga Nidra

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By John M. de Castro, Ph.D.

 

“The ancient practice of yoga nidra, also known as yogic sleep, is a meditative practice that results in conscious deep sleep. Current research suggests that yoga nidra can help relieve menstrual problems, diabetes symptoms and post-traumatic stress disorder (PTSD).” – Elaine Gavalas

 

Menstrual disorders are associated with disruptive physical and/or emotional symptoms just before and during menstruation, including heavy bleeding, missed periods and unmanageable mood swings. Symptoms can include abnormal uterine bleeding, which may be abnormally heavy or absent or occurs between periods, painful menstrual periods, premenstrual syndrome, or premenstrual dysphonic disorder (depression). These disorders are all very common and most women experience some of these symptoms sometime during their premenopausal years, while around 20% experience them throughout their fertile years.

 

Yoga has documented benefits for the individual’s psychological and physical health and well-being. It has also been shown to improve menstrual problems. Yoga, however, consists of a number of components including, poses, breathing exercises, yoga nidra (meditation), concentration, and philosophy/ethics.  So, it is difficult to determine which facet or combination of facets of yoga are responsible for which benefit. Hence, it is important to begin to test each component in isolation to determine its effects.

 

In today’s Research News article “Psycho-Biological Changes with Add on Yoga Nidra in Patients with Menstrual Disorders: a Randomized Clinical Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1255064667850790/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794540/

Rani and colleagues randomly assigned women who displayed menstrual disorders for more than 6-months to either a yoga Nidra or treatment as usual group. Yoga nidra is generally practiced while lying on the back on a mat on the floor with the arms out at the sides and the palm facing up. This is the what’s known as the corpse pose in yoga. It is generally a deep guided meditation practice. It usually begins with a systematic body scan meditation and then moves into a deep meditative state. The most easily observable effect of the yoga nidra practice is the extremely deep relaxation of the nervous system and healing of the body by allowing it the rest and recharge it usually lacks in our all too busy lifestyles. Yoga nidra produces a state of deep relaxation and sedation without the individual actually going to sleep.

 

At baseline Rani and colleagues measured psychological general well-being, and a variety of hormone levels. The yoga nidra group then received 30-35-minute yoga nidra, 5 days per week for 3 months and practiced at home for the subsequent 3 months. Measurements were then repeated at the end of the 6-month program. Control participants received their normal medical treatments during the 6-month period. They found that the yoga Nidra group showed significant improvements in anxiety, depression, positive well-being, general health, and vitality while the control group did not. Similarly, they found that the yoga Nidra group had significant decreases in 4 hormone levels; thyroid-stimulating hormone, follicle-stimulating hormone, luteinizing hormone, and prolactin. Hence, yoga Nidra produced positive benefits for psychological well-being and also for endocrine (hormonal) function.

 

These are exciting findings. Yoga Nidra practice improved psychological well-being in women with menstrual disorder. Yoga practice and meditation practice have these same benefits for practitioners. But, it’s interesting that these psychological benefits can be produced by yoga nidra practice alone. The findings of decreased hormone levels are significant. Pituitary hormones, follicle stimulating hormone, luteinizing hormones, prolactin and thyroid hormones are very much involved in the menstrual cycle and are required for normal development of ova. Yoga Nidra practice may be helping with menstrual disorder by producing better regulation of these crucial hormones. Future research will be required to investigate this idea.

 

It is important to note that the control group did not receive any new active treatment. It is possible that the effects observed were not due to yoga Nidra, but to the expectations of the participants that the yoga nidra would improve their disorder. It will be important for future research to include and active or placebo control condition.

 

Regardless, the results suggest that well-being can be improved in women with menstrual disorder with yoga nidra.

 

“Yoga nidra for me is like a ‘super nap’ that recharges me in no time. It is a complete rejuvenation package – a must to relieve ourselves of daily stress in today’s busy world.” – Pritika Nair

 

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

Rani, K., Tiwari, S. C., Kumar, S., Singh, U., Prakash, J., & Srivastava, N. (2016). Psycho-Biological Changes with Add on Yoga Nidra in Patients with Menstrual Disorders: a Randomized Clinical Trial. Journal of Caring Sciences,5(1), 1–9. http://doi.org/10.15171/jcs.2016.001

 

Abstract

Introduction: Menstrual disorders are common problems among women in the reproductive age group. Yuga interventions may decrease the physical and psychological problems related to menstrual disorders. The present study was aimed to assess the effect of Yoga Nidra on psychological problems in patients with menstrual disorders.

Methods: A total number of 100 women recruited from the department of obstetrics and gynecology and were then randomly allocated into two groups: a) intervention received yogic intervention and medication for 6 month, and b) control group received no yogic intervention and they only received prescribed medication). Psychological General Well-Being Index (PGWBI) and hormonal profile were assessed at the time of before and after six months on both groups.

Results: The mean score of anxiety, depression, positive well-being, general health, and vitality scores, as well as hormonal levels, in posttest were significantly different in intervention group as compared with pretest. But there was no significant difference in control group.

Conclusion: Yoga Nidra can be a successful therapy to overcome the psychiatric morbidity associated with menstrual irregularities. Therefore, Yogic relaxation training (Yoga Nidra) could be prescribed as an adjunct to conventional drug therapy for menstrual dysfunction.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794540/

 

Promote Adaptive Emotions with Mindful Non-Judgment

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By John M. de Castro, Ph.D.

 

“By cultivating such mindfulness of emotions, we can build our resiliency to handle all of the intense experiences associated with urban living. We can limit our ability to get hijacked by emotions, which can carry us away to undesired places (like getting on the wrong subway).” – Jonathan Kaplan

 

We are very emotional creatures. Without emotion, life is flat and uninteresting. Emotions provide the spice of life. We are constantly having or reacting to emotions. We often go to great lengths in an attempt to create or keep positive emotions and conversely to avoid, mitigate, or get rid of negative emotions. 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.

 

The importance of emotions is only surpassed by our ignorance of them. Our rational side tries to downplay their significance and as a result research studies of emotions are fairly sparse and often ridiculed by politicians. So there is a great need for research on the nature of emotions, their effects, how they are regulated or not, and what factors affect them. One important factor is mindfulness, which has been shown to affect our ability to regulate emotions. Research has demonstrated that 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.

 

In today’s Research News article “Mindfulness and Emotional Outcomes: Identifying Subgroups of College Students using Latent Profile Analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1235541963136394/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269250/

Pearson and colleagues explore the components of mindfulness and how they relate to emotions in college students. They measured mindfulness with the Five Facet Mindfulness Questionnaire (FFMQ) which measures the mindfulness components of observing, describing, acting with awareness, non-judging, and non-reactivity. Using sophisticated statistical analysis they were able to identify 4 distinct classes of student responses; a high mindfulness group that were relatively high on every facet of mindfulness; a low mindfulness group that were relatively low on every facet of mindfulness; a judgmentally observing group that is high in observing but very low on non-judging of inner experience and acting with awareness;  and a non-judgmentally aware group that were high on non-judging of inner experience and acting with awareness, but very low on the observing facet of mindfulness.

 

They found that the “high mindfulness” and “non-judgmentally aware” groups did not differ and had lower depressive symptoms, anxiety symptoms, affective lability, and distress intolerance. On the other hand, the “judgmentally observing” groups had higher depressive symptoms, anxiety symptoms, affective lability, and distress intolerance. Finally, they found that the “low mindfulness group” was in the middle significantly better than the “judgmentally observing” group, but significantly worse than the “non-judgmentally aware” and “high mindfulness groups” in adaptive emotionality. Hence, having high mindfulness and being aware without judging are associated with relatively positive emotional states while observing while judging experiences is associated with relatively negative emotional states. Simply being low in mindfulness is associated with an average emotional state.

 

These results suggest that mindfulness is associated with positive emotional states but judging experience is associated with poor emotional states. So, being overall mindful and particularly non-judging leads to the most adaptive emotional states. This reinforces the previous findings of mindfulness promotion emotional regulation. But, they extend this understanding to emphasize just how important judging experience is; if its judged it leads to poor emotional outcomes while if it’s not, it leads to positive emotional outcomes. Although correlational these observations suggest that emotional states can be elevated with mindful non-judgement.

 

So, promote adaptive emotions with mindful non-judgment.

 

“For many of us, instead of feeling our emotions, we criticize ourselves for having them. We call ourselves weak, dramatic, stupid, too sensitive. . . we get angry with ourselves for feeling scared or upset. We become disgusted when we’re jealous of others. We get frustrated when we’re still grieving a breakup or a fight. The key is to accept our emotions.” – Margarita Tartakovsky

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Pearson, M. R., Lawless, A. K., Brown, D. B., & Bravo, A. J. (2015). Mindfulness and Emotional Outcomes: Identifying Subgroups of College Students using Latent Profile Analysis. Personality and Individual Differences,76, 33–38. http://doi.org/10.1016/j.paid.2014.11.009

 

Highlights

  • We used latent profile analysis to group college students based on mindfulness scores
  • A 4-class solution was selected, leading to four subgroups of college students
  • High mindfulness and non-judgmentally aware groups had adaptive outcomes
  • Low mindfulness and judgmentally observing groups had maladaptive outcomes
  • We discuss the implications of person-centered analyses for studying mindfulness

Abstract

In non-meditating samples, distinct facets of mindfulness are found to be negatively correlated, preventing the meaningful creation of a total mindfulness score. The present study used person-centered analyses to distinguish subgroups of college students based on their mindfulness scores, which allows the examination of individuals who are high (or low) on all facets of mindfulness. Using the Lo-Mendell-Rubin Adjusted LRT test, we settled on a 4-class solution that included a high mindfulness group (high on all 5 facets, N = 245), low mindfulness group (moderately low on all 5 facets, N = 563), judgmentally observing group (high on observing, but low on non-judging and acting with awareness, N =63), and non-judgmentally aware group (low on observing, but high on non-judging and acting with awareness, N =70). Consistent across all emotional outcomes including depressive symptoms, anxiety symptoms (i.e., worry), affective instability, and distress intolerance, we found that the judgmentally observing group had the most maladaptive emotional outcomes followed by the low mindfulness group. Both the high mindfulness group and the non-judgmentally aware group had the most adaptive emotional outcomes. We discuss the implications of person-centered analyses to exploring mindfulness as it relates to important psychological health outcomes.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269250/

Relieve Uncertainty and Panic Disorder with Mindfulness

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By John M. de Castro, Ph.D.

 

“Panic gains momentum from the energy we put into fighting it, and the fact is, we don’t always need to fight it. Life happens to you and me as it happens to all people, whether we are ready for it or not, and all we really need to do is be open to experiencing it one moment at a time.” – Krista Lester

 

Anxiety and fear happen in everyone and under normal conditions are coped with adaptively and effectively and do not continue beyond the eliciting conditions. But, in a large number of people the anxiety is non-specific and overwhelming. Anxiety Disorders are the most common psychological problem. In the U.S., they affect over 40 million adults, 18% of the population, with women accounting for 60% of sufferers They typically include feelings of panic, fear, and uneasiness, problems sleeping, cold or sweaty hands and/or feet, shortness of breath, heart palpitations, an inability to be still and calm, dry mouth, and numbness or tingling in the hands or feet.

 

A subset of people with anxiety disorders are diagnosed with Panic Disorder. These are sudden attacks of fear and nervousness, as well as physical symptoms such as difficulty breathing, pounding heart or chest pain, intense feeling of dread, shortness of breath, sensation of choking or smothering, dizziness or feeling faint, trembling or shaking, sweating, nausea or stomachache, tingling or numbness in the fingers and toes, chills or hot flashes, and a fear that they are losing control or are about to die. A common additional symptom of panic disorder is the persistent fear of having future panic attacks. The fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where they believe an attack may occur. Needless to say patients are miserable, their quality of life is low, and their ability to carry on a normal life disrupted.

 

There are a number of treatments for Panic Disorder including psychotherapy, relaxation training, and medication. Recently it’s been demonstrated that panic disorder can be treated with mindfulness practice. In particular, Mindfulness Based Cognitive Therapy (MBCT) has been shown to be particularly effective. It is not known, however, the exact mechanism of action of MBCT effects on Panic Disorder. In today’s Research News article “Impact of Mindfulness-Based Cognitive Therapy on Intolerance of Uncertainty in Patients with Panic Disorder.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1232976826726241/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823195/

Kim and colleagues investigate whether an intolerance of uncertainty may be a key factor in Panic Disorder and the response to MBCT. Intolerance of uncertainty is defined as a “dispositional characteristic that results from a set of negative beliefs about uncertainty and its implications, and involves the tendency to react negatively on an emotional, cognitive, and behavioral level to uncertain situations and events.”

 

Kim and colleagues recruited patients suffering with Panic Disorder and treated them with an 8-week program of Mindfulness Based Cognitive Therapy (MBCT). They measured Panic Disorder intensity, depression, and intolerance of uncertainty both before and after treatment. They found that MBCT produced significant decreases in all measures, with patients having significantly lower levels of Panic Disorder intensity, depression, and intolerance of uncertainty after treatment. They also found that before treatment, the higher the level of intolerance of uncertainty, the greater the intensity of Panic Disorder and the higher the level of depression. In addition, the greater the reduction in intolerance of uncertainty produced by MBCT, the greater the reduction in Panic Disorder intensity. The significant association between intolerance of uncertainty and Panic Disorder intensity was present even after the pre-treatment level of Panic Disorder intensity and Depression were accounted for.

 

These results suggest that Mindfulness Based Cognitive Therapy (MBCT) is an effective treatment for Panic Disorder. They further suggest that the effectiveness of MBCT is at least in part due to it reducing the intolerance of uncertainty that is characteristic of Panic Disorder patients. Mindfulness training in general and MBCT in particular increase attention to what is transpiring in the present moment and decrease thinking about the future. Since intolerance of uncertainty is a worry about future events, it would seem reasonable that MBCT would reduce it. Since intolerance of uncertainty is clearly related to Panic Disorder, its reduction should reduce Panic Disorder.

 

It should be noted that the study did not contain a control (comparison) condition. So, it cannot be concluded that MBCT was responsible for the improvements. It is possible that a placebo effect or spontaneous remissions were responsible. Regardless, the results are suggestive that MBCT is a safe and effective intervention for the relief of Panic Disorder, depression, and intolerance of uncertainty. So, relieve uncertainty and panic disorder with mindfulness.

 

“mindfulness takes ‘thinker’ out of thought, and teaches us to step back and observe our minds and our thoughts. Mindfulness is learning to see exactly what is happening. It ‘disengages’ our ‘automatic pilot’ and gives us the necessary space to see cause and effect as it happens in ‘real’ time. Cause: thought. Effect: panic and/or anxiety.” – Bronwyn Fox

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Kim, M. K., Lee, K. S., Kim, B., Choi, T. K., & Lee, S.-H. (2016). Impact of Mindfulness-Based Cognitive Therapy on Intolerance of Uncertainty in Patients with Panic Disorder. Psychiatry Investigation, 13(2), 196–202. http://doi.org/10.4306/pi.2016.13.2.196

 

Abstract

Objective: Intolerance of uncertainty (IU) is a transdiagnostic construct in various anxiety and depressive disorders. However, the relationship between IU and panic symptom severity is not yet fully understood. We examined the relationship between IU, panic, and depressive symptoms during mindfulness-based cognitive therapy (MBCT) in patients with panic disorder.

Methods: We screened 83 patients with panic disorder and subsequently enrolled 69 of them in the present study. Patients participating in MBCT for panic disorder were evaluated at baseline and at 8 weeks using the Intolerance of Uncertainty Scale (IUS), Panic Disorder Severity Scale-Self Report (PDSS-SR), and Beck Depression Inventory (BDI).

Results: There was a significant decrease in scores on the IUS (p<0.001), PDSS (p<0.001), and BDI (p<0.001) following MBCT for panic disorder. Pre-treatment IUS scores significantly correlated with pre-treatment PDSS (p=0.003) and BDI (p=0.003) scores. We also found a significant association between the reduction in IU and PDSS after controlling for the reduction in the BDI score (p<0.001).

Conclusion: IU may play a critical role in the diagnosis and treatment of panic disorder. MBCT is effective in lowering IU in patients with panic disorder.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823195/

 

Relieve Depression with Mindful Meditation

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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. It is generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression. 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, 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, including insomnia or sleeping too much, tiredness and lack of energy, so even small tasks take extra effort, changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people, anxiety, agitation or restlessness, slowed thinking, speaking or body movements, feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility, trouble thinking, concentrating, making decisions and remembering things, frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide, unexplained physical problems, such as back pain or headaches. 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.

 

Mindful meditation training is a viable alternative treatment for depression. It has been shown to be an effective treatment for active depression and for the prevention of its recurrence. It can even be effective in cases where drugs fail. In today’s Research News article “Critical Analysis of the Efficacy of Meditation Therapies for Acute and Subacute Phase Treatment of Depressive Disorders: A Systematic Review.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1232267610130496/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383597/

Jain and colleagues investigated the state of knowledge regarding mindful meditation effectiveness for depression. They reviewed the published research literature on the application of mindful meditation training to the relief of depression and/or the prevention of relapse. Meditation occurred in a variety of different techniques, meditation, yoga, mindful movement (i.e. Tai Chi), and mantra meditation. The most frequent technique (57% of studies) was Mindfulness Based Cognitive Therapy (MBCT). This was not a surprise as MBCT was developed specifically to treat depression.

 

They reported that the research results made a clear case that meditation therapies are effective for depression. They were effective in relieving depression when the patient was experiencing an active episode and also when the patient had recovered from major depression but was experiencing residual depressive symptoms. Thus, the published research is clear that mindful meditation is an effective treatment for depression. They caution, however, that more research is needed to unequivocally demonstrate its effectiveness under more highly controlled conditions.

 

It is not known exactly how meditation 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 mindfulness meditation is a safe and effective treatment for depression.

 

“It’s been more than two years since I started that experiment. I have not missed a single day. And I’m going to tell you right now, still in half-disbelief myself: meditation worked. I don’t mean I feel a little better. I mean the Depression is gone. Completely. I still have very hard days, yes. But when issues come up, real or imagined (or a combination of both), meditation provides an awareness that helps me sort through it all, stay steady on, and understand deeply what is going on. “ – Spike Gillespie

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Jain, F. A., Walsh, R. N., Eisendrath, S. J., Christensen, S., & Cahn, B. R. (2015). Critical Analysis of the Efficacy of Meditation Therapies for Acute and Subacute Phase Treatment of Depressive Disorders: A Systematic Review. Psychosomatics, 56(2), 140–152. http://doi.org/10.1016/j.psym.2014.10.007

 

Abstract

Background: Recently, the application of meditative practices to the treatment of depressive disorders has met with increasing clinical and scientific interest, due to a lower side-effect burden, potential reduction of polypharmacy, as well as theoretical considerations that such interventions may target some of the cognitive roots of depression. We aimed to determine the state of the evidence supporting this application.

Methods Randomized, controlled trials of techniques meeting the Agency for Healthcare Research and Quality (AHRQ) definition of meditation, for participants suffering from clinically diagnosed depressive disorders, not currently in remission, were selected. Meditation therapies were separated into praxis (i.e. how they were applied) components, and trial outcomes were reviewed.

Results: Eighteen studies meeting inclusionary criteria were identified, encompassing seven distinct techniques and 1173 patients, with Mindfulness-Based Cognitive Therapy comprising the largest proportion. Studies including patients suffering from acute major depressive episodes (N = 10 studies), and those with residual subacute clinical symptoms despite initial treatment (N = 8), demonstrated moderate to large reductions in depression symptoms within group, and relative to control groups. There was significant heterogeneity of techniques and trial designs.

Conclusions: A substantial body of evidence indicates that meditation therapies may have salutary effects on patients suffering from clinical depressive disorders during the acute and subacute phases of treatment. Due to methodological deficiences and trial heterogeneity, large-scale, randomized controlled trials with well-described comparator interventions and measures of expectation are needed to clarify the role of meditation in the depression treatment armamentarium.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383597/

Cope with Violence Trauma with Mindfulness

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By John M. de Castro, Ph.D.

 

“People with PTSD ruminate, and rumination is all about not being present. It’s all about focusing on something terrible that happened in the past or something frightening that will happen in the future, so these patients are stuck in a rut. My personal bias is that mindfulness-based therapy has a big effect on rumination, and decreasing rumination allows people to experience the present moment, which expands their awareness of different possibilities and increases their ability to pay attention to things they have avoided in the past,” – Anthony King

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. Many, but, only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life.

 

PTSD can be produced by traumatic events occurring to anyone in a variety of different contexts. These include interpersonal violence (IPV). It is defined “as the intentional use of physical or sexual violence against another person within the context of a relationship. This includes physical or sexual violence committed by a family member, intimate partner, friend, or acquaintance.” A frequent form of IPV is intimate partner violence. Indeed, 27% of women and 11% of men have reported that they had been harmed by sexual or physical violence at some time during their lives.

 

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

 

Obviously, these are serious and troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective. In today’s Research News article “Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results from a Stage I RCT.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1227840437239880/?type=3&theater

or below

Kelly and Garland randomly assigned adult female survivors of interpersonal violence (IPV) to either an 8-week mindfulness training or wait-list control condition. The intervention was a form of Mindfulness Based Stress Reduction (MBSR) that was modified for treatment with trauma survivors.

 

They found that the treatment produced a clinically significant decrease in PTSD symptoms to the point where a significant number of participants could no longer be classified as PTSD sufferers. The more the participant practiced the mindfulness training the greater the reduction in PTSD symptoms. There were also significant decreases in the mindfulness group in depression and anxious attachment. Anxious attachment is a symptom of PTSD that involves “vacillating between attempts to draw in significant others with endearing attention-seeking behaviors and attempts to attract attention through emotional outbursts of crying or anger.” Reducing anxious attachment allows the sufferer to conduct much healthier interpersonal relationships.

 

These are very promising results that suggest that the modified form of Mindfulness Based Stress Reduction (MBSR) is a safe and effective treatment for PTSD caused by interpersonal violence (IPV). It is not known how mindfulness training could be so effective for PTSD. It can be speculated that the improvement in present moment awareness might have helped by focusing on the individual on the present rather than the past when the trauma occurred and by reducing rumination about the past. In addition, mindfulness training is known to improve emotion regulation and this may allow the PTSD sufferers to not avoid but fully experience the emotions and then respond to them in a constructive fashion. Finally, mindfulness training is known to reduce the physiological and psychological responses to stress. This lowered stress levels may reduce the intensity of their response to memories of the trauma, allowing the individual to be able to internally address the events directly.

 

Regardless of the mechanism, it is clear that mindfulness training is an effective treatment for PTSD symptoms caused by interpersonal violence (IPV). So, cope with violence trauma with mindfulness.

 

“Mindfulness-based stress reduction teaches individuals to attend to the present moment, to attend to what they are experiencing — their thoughts, their feelings — in a nonjudgmental, accepting manner. We think that teaching people these mindfulness skills helps them to have a different relationship with their PTSD symptoms — a willingness to let thoughts be there without trying to push them away,” -Melissa Polusny

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Kelly, A. and Garland, E. L. (2016), Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results From a Stage I RCT. J. Clin. Psychol., 72: 311–328. doi:10.1002/jclp.22273

 

Abstract

OBJECTIVE: This pilot randomized controlled trial evaluated a novel trauma-informed model of mindfulness-based stress reduction (TI-MBSR) as a phase I trauma intervention for female survivors of interpersonal violence (IPV).

METHOD: A community-based sample of women (mean age = 41.5, standard deviation = 14.6) with a history of IPV was randomly assigned to an 8-week TI-MBSR intervention (n = 23) or a waitlist control group (n = 22). Symptoms of posttraumatic stress disorder (PTSD) and depression as well as anxious and avoidant attachment were assessed pre- and postintervention.

RESULTS: Relative to the control group, participation in TI-MBSR was associated with statistically and clinically significant decreases in PTSD and depressive symptoms and significant reductions in anxious attachment. Retention in the intervention was high, with most participants completing at least 5 of the 8 sessions for the intervention. Minutes of mindfulness practice per week significantly predicted reductions in PTSD symptoms.

CONCLUSION: TI-MBSR appears to be a promising and feasible phase I intervention for female survivors of interpersonal trauma.

 

Relieve Depression with Meditation and Exercise

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Meditation Exercise Brain depression2 Alderman

By John M. de Castro, Ph.D.

 

“Studies have already suggested that physical activity can play a powerful role in reducing depression; newer, separate research is showing that meditation does, too. Now some exercise scientists and neuroscientists believe there may be a uniquely powerful benefit in combining the two.” – Melissa Dahl

 

Major Depressive Disorder (MDD) is a severe mood disorder that includes mood dysregulation and cognitive impairment. It is estimated that 16 million adults in the U.S. (6.9% of the population suffered from major depression in the past year and affects females (8.4%) to a great extent than males (5.2%). It is second-leading cause of disability in the world following heart disease. The usual treatment of choice for MDD is drug treatment. In fact, it is estimated that 10% of the U.S. population is taking some form of antidepressant medication. But a substantial proportion of patients (~40%) do not respond to drug treatment. In addition, the drugs can have nasty side effects. So, there is need to explore other treatment options.

 

It has been shown that aerobic exercise can help to relieve depression. But, depressed individuals lack energy and motivation and it is difficult to get them to exercise regularly. As a result, aerobic exercise has not been used very often as a treatment. Recently, it has become clear that mindfulness practices are effective for the relief of major depressive disorder and as a preventative measure to discourage relapses. Mindfulness can be used as a stand-alone treatment or in combination with drugs. It is even effective when drugs fail to relieve the depression.

 

As yet there has been no attempt to combine aerobic exercise and mindfulness training for major depressive disorder. It is possible that mindfulness practice may improve depression sufficiently to energize the individual to engage in aerobic exercise. So, the combination may be uniquely beneficial. In today’s Research News article “MAP training: combining meditation and aerobic exercise reduces depression and rumination while enhancing synchronized brain activity”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1217959668227957/?type=3&theater

http://www.nature.com/tp/journal/v6/n2/full/tp2015225a.html

Alderman and colleagues employ a combination of 20 minutes of minutes of sitting meditation followed immediately by 10 minutes of walking meditation with 30 minutes of aerobic exercise either on a treadmill or stationary bicycle. They tested the impact of this combination on a group of adults with major depressive disorder and a group of healthy non-depressed individuals.

 

They found that the treatment reduced depression in both groups but to a much greater extent with the depressed patients, reducing it by 40%. The treatment also reduced ruminative thinking in both groups. They also found that the combined aerobic exercise and mindfulness training changed the brains response to a cognitive task. After training there was a larger N2 (negative response) observed in the brains evoked electrical activity (ERP) and a larger P3 (positive response) in the ERP in response to the cognitive task.

 

The P3 response in the evoked potential (ERP) occurs around a quarter of a second following the stimulus presentation. It is a positive change that is maximally measured over the central frontal lobe. The P3 response has been associated with the engagement of attention. So, the P3 response is often used as a measure of brain attentional processing with the larger the positive change the greater the attentional focus. The N2 response in the evoked potential (ERP) generally precedes the P3 response. It is a negative change that is maximally measured over the frontal lobe. The N2 response has been associated with the engagement of attention to a new or novel stimulus. So, the N2 response is often used as a measure of brain attentional processing with the large the negative changes an indication of greater discrimination of new stimuli.

 

The findings indicate that the combination training improves brain electrical activity indicators of attention and stimulus discrimination during a cognitive task. It was also found that the size of the N2 response was negatively related to the amount of decrease in ruminative thought. Ruminative thought which requires attention to memories of the past and attention to the present cannot occur at the same time. So, by improving attention the training appeared to improve attention to the present and thereby decrease rumination which is a major contributor to the depressed state.

 

These are interesting and exciting results that suggest that the combination of mindfulness and aerobic exercise training may be a potent and effective treatment for major depressive disorder. This is particularly important as aerobic exercise and mindfulness training both have many other physical and psychological benefits and have minimal side effects. They may, in part, be effective by improving attention and thereby decreasing rumination in depressed patients. Given the design of the present study it is not possible to determine if the combination is more effective the either component alone or the sum of their independent effectiveness. Future research should address this issue.

 

So, relieve depression with meditation and exercise.

 

“We know these therapies can be practiced over a lifetime and that they will be effective in improving mental and cognitive health. The good news is that this intervention can be practiced by anyone at any time and at no cost.” – Brandon Alderman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

Study Summary

 

B L Alderman, R L Olson, C J Brush and T J Shors. MAP training: combining meditation and aerobic exercise reduces depression and rumination while enhancing synchronized brain activity. Translational Psychiatry (2016) 6, e726; doi:10.1038/tp.2015.225. Published online 2 February 2016

 

Abstract

Mental and physical (MAP) training is a novel clinical intervention that combines mental training through meditation and physical training through aerobic exercise. The intervention was translated from neuroscientific studies indicating that MAP training increases neurogenesis in the adult brain. Each session consisted of 30 min of focused-attention (FA) meditation and 30 min of moderate-intensity aerobic exercise. Fifty-two participants completed the 8-week intervention, which consisted of two sessions per week. Following the intervention, individuals with major depressive disorder (MDD; n=22) reported significantly less depressive symptoms and ruminative thoughts. Typical healthy individuals (n=30) also reported less depressive symptoms at follow-up. Behavioral and event-related potential indices of cognitive control were collected at baseline and follow-up during a modified flanker task. Following MAP training, N2 and P3 component amplitudes increased relative to baseline, especially among individuals with MDD. These data indicate enhanced neural responses during the detection and resolution of conflicting stimuli. Although previous research has supported the individual beneficial effects of aerobic exercise and meditation for depression, these findings indicate that a combination of the two may be particularly effective in increasing cognitive control processes and decreasing ruminative thought patterns.

http://www.nature.com/tp/journal/v6/n2/full/tp2015225a.html

 

Change the Depressed Brain with Meditation

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Meditation brain depression2 Yang

By John M. de Castro, Ph.D.

 

“Meditation isn’t a magic bullet for depression, as no treatment is, but it’s one of the tools that may help manage symptoms.” – Alice Walton

 

Depression is the most common mental illness affecting over 6% of the population.  It is debilitating by producing any or all of a long list of symptoms including: feelings of sadness or unhappiness, change in appetite or weight, slowed thinking or speech, loss of interest in activities or social gatherings, fatigue, loss in energy, sleeplessness, feelings of guilt or anger over past failures, trouble concentrating, indecisiveness, anger or frustration for no distinct reason, thoughts of dying, death and suicide. 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 of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. This leaves a third of all patients treated without success.

 

Mindfulness practices have been demonstrated to be beneficial for depression. They not only reduce depression levels in relatively normal people but also relieve depression in individual with major depression. They can even help in cases where drugs fail to relieve the depression. In addition, mindfulness practices can reduce the likelihood of a relapse after successful treatment for depression. In other words, mindfulness is an effective treatment either alone or in combination with drugs for depression.

 

In the last few decades it has become increasingly clear that the brain is very plastic and can be reshaped by what we do and what we experience. This has been called neuroplasticity. Contemplative practices have been shown to produce neuroplastic change altering the brain. They tend to increase the size, activity, and connectivity of areas of the brain that are important for attention, and emotion regulation while reducing the size, activity, and connectivity of areas of the brain that are involved in mind wandering and self-centered thinking, daydreaming, and rumination.

 

Mindfulness practices appear to take advantage of neuroplasticity to act upon the chemistry of the brain and brain electrical activity to help relieve depression. Hence, it makes sense that there should be further research on the effects of mindfulness on the brain and depression to better understand the mechanisms of action of mindfulness and potentially optimize treatment. In today’s Research News article “State and Training Effects of Mindfulness Meditation on Brain Networks Reflect Neuronal Mechanisms of Its Antidepressant Effect”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779536/

Yang and colleagues trained meditation naive college students for 8-weeks with a mindfulness program based upon a combination of Mindfulness Based Stress Reduction (MBSR) and Acceptance and Commitment Therapy (ACT). Functional Magnetic Resonance Imaging (f-MRI) brain scans were performed before training and 40 days later both at rest and during meditation. The students emotional state and depression levels were also measured before and after training.

 

After mindfulness training there was a 45% reduction in depression, a 21% reduction in trait anxiety, and a small reduction in tension. The brain was also found to be changed at rest after training. The changes were many and diverse. But arguably the most interesting change was a reduction in the functional connectivity between the pregenual anterior cingulate and dorsal medical prefrontal cortex. The anterior cingulate cortex is part of what is called the default mode network that is activated during mind wandering and emotionality. It is involved in major depression and the loss of emotionality, so called flat affect, that characterizes depression. On the other hand, the dorsal medical prefrontal cortex is involved in focused attention, cognitive control, and emotion regulation. These results are very complex and must be interpreted cautiously. But, it appears that meditation training reduces the ability of areas involved in depression from affecting areas involved in thought and emotion. This is a potential route for mindfulness affects in relieving depression.

 

Regardless, it’s clear that mindfulness can change the depressed brain.

 

“We can intentionally shape the direction of plasticity changes in our brain. By focusing on wholesome thoughts, for example, and directing our intentions in those ways, we can potentially influence the plasticity of our brains and shape them in ways that can be beneficial.” – Richie Davidson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

 

Yang, C.-C., Barrós-Loscertales, A., Pinazo, D., Ventura-Campos, N., Borchardt, V., Bustamante, J.-C., … Walter, M. (2016). State and Training Effects of Mindfulness Meditation on Brain Networks Reflect Neuronal Mechanisms of Its Antidepressant Effect. Neural Plasticity, 2016, 9504642. http://doi.org/10.1155/2016/9504642

 

Abstract

The topic of investigating how mindfulness meditation training can have antidepressant effects via plastic changes in both resting state and meditation state brain activity is important in the rapidly emerging field of neuroplasticity. In the present study, we used a longitudinal design investigating resting state fMRI both before and after 40 days of meditation training in 13 novices. After training, we compared differences in network connectivity between rest and meditation using common resting state functional connectivity methods. Interregional methods were paired with local measures such as Regional Homogeneity. As expected, significant differences in functional connectivity both between states (rest versus meditation) and between time points (before versus after training) were observed. During meditation, the internal consistency in the precuneus and the temporoparietal junction increased, while the internal consistency of frontal brain regions decreased. A follow-up analysis of regional connectivity of the dorsal anterior cingulate cortex further revealed reduced connectivity with anterior insula during meditation. After meditation training, reduced resting state functional connectivity between the pregenual anterior cingulate and dorsal medical prefrontal cortex was observed. Most importantly, significantly reduced depression/anxiety scores were observed after training. Hence, these findings suggest that mindfulness meditation might be of therapeutic use by inducing plasticity related network changes altering the neuronal basis of affective disorders such as depression.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779536/

 

Prevent Depression Relapse Better with Both Mindfulness and Drugs

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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

 

Major Depression is the most common mental illness, affecting over 6% of the population. It 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 not only treat the disease initially, but also to employ strategies to decrease or prevent relapse.

 

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 “Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial”

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Huijbers and colleagues recruited patients who had had three or more depressive episodes, were being treated with anti-depressive medications for at least six months, and were currently in remission. All patients then received an 8-week Mindfulness Based Cognitive Therapy (MBCT) program. MBCT included meditation, body scan, and mindful movement as well as exercises to bring present-moment awareness to everyday activities. Cognitive therapy included education, monitoring and scheduling of activities, identification of negative automatic thoughts and devising a relapse prevention plan. At the conclusion of treatment patients were randomly assigned to have the drugs withdrawn over five weeks or to continue receiving drugs.

 

Huijbers and colleagues found that at 15 months after MBCT treatment there was a 25% higher rate of relapse when the drugs were withdrawn compared to when they were maintained. In addition, the amount of time to relapse/recurrence was significantly shorter after discontinuation of the drugs. This suggests that withdrawing the drugs increases the risk of relapse/recurrence for patients in remission from major depression and suggests that the combination of MBCT along with a maintenance dose of drug is superior in preventing relapse.

 

So, prevent depression relapse better with both mindfulness and drugs.

 

“Because [mindfulness-based cognitive therapy] is a group treatment which reduces costs and the number of trained staff needed it may be feasible to offer MBCT as a choice to patients in general practice…We therefore have a promising relatively new treatment which is reasonably cost effective and applicable to the large group of patients with recurrent depression.” – Roger Mulder

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

Study Summary

 

Marloes J. Huijbers, Philip Spinhoven, Jan Spijker, Henricus G. Ruhé, Digna J. F. van Schaik, Patricia van Oppen, Willem A. Nolen,Johan Ormel, Willem Kuyken, Gert Jan van der Wilt, Marc B. J. Blom, Aart H. Schene, A. Rogier T. Donders, Anne E. M. Speckens. Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial. The British Journal of Psychiatry Feb 2016, DOI: 10.1192/bjp.bp.115.168971

Abstract

Background: Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied.

Aims: To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM.

Method: A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov: NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n = 249), were randomly allocated to either discontinue (n = 128) or continue (n = 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity.

Results: The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity.

Conclusions: Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT.

 

Keep Health Care Professionals from Burning Out with Mindfulness

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By John M. de Castro, Ph.D.

 

“Through practicing mindfulness we become more aware of subtle changes in our mood and physical health, and can start to notice more quickly when we are struggling. Rather than waiting for a full meltdown before we take action, we can read the signals of our minds and bodies and start to take better care of ourselves.” – The Mindfulness Project

 

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, emotional exhaustion, and professional inefficacy that comes with work-related stress. Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout with emergency medicine at the top of the list, over half experiencing burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity.

 

Burnout is not a unitary phenomenon. In fact, there appear to be a number of subtypes of burnout. The overload subtype is characterized by the perception of jeopardizing one’s health to pursue worthwhile results, and is highly associated with exhaustion. The lack of development subtype is characterized by the perception of a lack of personal growth, together with the desire for a more rewarding occupation that better corresponds to one’s abilities. The neglect subtype is characterized by an inattentive and careless response to responsibilities, and is closely associated with inefficacy. All of these types result from an emotional exhaustion. This exhaustion not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion.

 

Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses. Hence, preventing existing healthcare workers from burning has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout. One of the premiere techniques for developing mindfulness and dealing effectively with stress is Mindfulness Based Stress Reduction (MBSR) pioneered by Jon Kabat-Zinn. It is a diverse mindfulness training containing practice in meditation, body scan, and yoga. As a result, there have been a number of trials investigating the application of MBSR to the treatment and prevention of health care worker burnout.

 

In today’s Research News article “Outcomes of MBSR or MBSR-based interventions in health care providers: A systematic review with a focus on empathy and emotional competencies”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1197241983633059/?type=3&theater

http://www.complementarytherapiesinmedicine.com/article/S0965-2299(15)30014-5/fulltext

Lamothe and colleagues summarize the published literature on the effectiveness of Mindfulness Based Stress Reduction (MBSR) for healthcare worker burnout. They found that the preponderance of evidence from a variety of different trials indicated that MBSR treatment is effective for burnout. In particular, the research generally reports that MBSR treatment significantly improves mindfulness, empathy, and the mental health of healthcare workers. It was found to significantly relieve burnout, and reduce anxiety, depression, and perceived stress.

 

Hence, the published literature is highly supportive of the application of MBSR for the prevention and treatment of healthcare worker burnout. It appears to not only help the worker, but the improvement in the empathy of the worker projects positive consequences for the patients. In addition, the reduction in burnout suggests that MBSR treatment may help to reduce healthcare workers leaving the field, helping to relieve the systemic lack of providers. These are remarkable and potentially very important results.

 

Mindfulness training makes the individual more aware of their own immediate physical and emotional state. Since this occurs in real time, it provides the individual the opportunity to recognize what is happening and respond to it effectively before it contributes to an overall state of burnout. Indeed, mindfulness training has been shown to significantly improve emotion regulation. This produces clear experiencing of the emotion in combination with the ability to respond to the emotion adaptively and effectively. So, the healthcare worker can recognize their state, realize its origins, not let it affect their performance, and respond to it appropriately, perhaps by the recognition that rest is needed.

 

So, keep health care professionals from burning out with mindfulness.

 

“It helps people to undo some of the sense of the time pressure and urgency that makes it so hard to feel present for your patient, and it helps your patients feel like you’re really there, really listening and that you really care. What you learn is to undo the distractedness that comes with worrying about what happens next, and the concern with what’s already over and done with. It doesn’t take more time; it takes an intention and practice to do it successfully.” –  Dr. Michael Baime

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Change Major Depression Brain Chemistry with Mindfulness

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MBCT Major Depression2 Li

By John M. de Castro, Ph.D.

 

“Mindfulness-based cognitive therapy helps participants in the classes to see more clearly the patterns of the mind; and to learn how to recognize when their mood is beginning to go down. It helps break the link between negative mood and the negative thinking that it would normally have triggered. Participants develop the capacity to allow distressing mood, thoughts and sensations to come and go, without having to battle with them. They find that they can stay in touch with the present moment, without having to ruminate about the past, or worry about the future.” – Center for Suicide Research

 

Major Depressive Disorder (MDD) is a severe mood disorder that includes mood dysregulation and cognitive impairment. It is estimated that 16 million adults in the U.S. (6.9% of the population suffered from major depression in the past year and affects females (8.4%) to a great extent than males (5.2%). It’s the second-leading cause of disability in the world following heart disease. It has also been shown that depression is, to a large extent, inherited, but can also be affected by the environment. Since the genes basically encode when, where, and how chemicals are produced, it is likely that there are changes in brain chemistry produced by the genes responsible for Major Depressive Disorder.

 

The usual treatment of choice for MDD is drug treatment. This supports the altered brain chemistry notion for MDD since the most effective treatment for MDD, drug treatment, changes brain chemistry. In fact, it is estimated that 10% of the U.S. population is taking some form of antidepressant medication. But a substantial proportion of patients (~40%) do not respond to drug treatment. In addition, the drugs can have nasty side effects. So, there is need to explore other treatment options.

 

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. It makes sense that if altered brain chemistry underlies MDD and that MBCT is an effective treatment for MDD, then MBCT must in some way change brain chemistry. In today’s Research News article “Evaluating metabolites in patients with major depressive disorder who received mindfulness-based cognitive therapy and healthy controls using short echo MRSI at 7 Tesla”

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Li and colleagues explore brain chemistry changes in Major Depressive Disorder (MDD) and the effects of Mindfulness Based Cognitive Therapy (MBCT) on those brain chemistry changes.

 

They recruited patients who were diagnosed with MDD but who were not currently taking antidepressant drugs and who were not practicing meditation or yoga. The brains of these patients and healthy controls were scanned with a powerful imaging technique called Magnetic Resonance Spectroscopic Imaging (MRSI). It is capable of non-invasively detecting levels of particular chemicals in the brain. The patients then received an 8-week MBCT group therapy followed by rescanning of the brains for the same chemicals.

 

They found that the MDD patients compared to healthy controls had elevated levels of choline-containing compounds and decreased levels of N-acetyl aspartate, myo-inositol, and glutathione.

These chemicals are breakdown products of active brain chemicals (metabolites). These are all markers of brain function. The heightened levels of choline-containing compounds suggests that there is with increased cell density and/or membrane turnover in MDD. The decreased levels of N-acetyl aspartate suggest that there is a loss of neurons or neuronal function in MDD. The decreased levels of myo-inositol suggest that there is a loss of or dysfunction of glial cells in MDD. Finally, the decreased levels of glutathione suggest that there is a lower level of neuron excitation in the brain in MDD.

 

Importantly, Li and colleagues found that MBCT significantly reduced depression levels and at the same time normalized the levels of all of the metabolites that had abnormal levels in the patients. These are potentially important results. They demonstrate altered brain chemistry in MDD suggestive of dysfunction in the normal activities of the nervous system and point to potential causal factors in MDD. They also provide suggestions as to how MBCT changes the brain to effectively treat MDD.

 

It should be noted that the changes in metabolites in Major Depressive Disorder may be the result of the depression rather than its cause. The fact that the changes vanished after treatment reduced depression tends to support this contention. It is a complex disease effecting the most complex entity in the universe, the human brain. Hence, there is still a lot of work to do to determine the causal factors in MDD.

 

Regardless, change major depression brain chemistry with mindfulness.

 

 “Mindfulness is the only thing I know to do that can dig me out of despair and give me even a few seconds of time out from me,” – Ruby Wax

 

CMCS – Center for Mindfulness and Contemplative Studies