Depression

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”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1217282338295690/?type=3&theater

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”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1196100317080559/?type=3&theater

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

Change Brain Activity in Depression with Mindfulness

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By John M. de Castro, Ph.D.

 

“Skeptics, of course, may ask what good are a few brain changes if the psychological effects aren’t simultaneously being illustrated? Luckily, there’s good evidence for those as well, with studies reporting that meditation helps relieve our subjective levels of anxiety and depression, and improve attention, concentration, and overall psychological well-being.” – Alice Walton

 

In the last few decades, scientists have discovered that the brain is far more malleable than previously thought. Areas in the brain can change, either increase or decrease in size, connectivity, and activity in response to changes in our environment or the behaviors we engage in. This process is referred to as neuroplasticity. The nervous system is constantly changing and adapting to the environment. For example, the brain area that controls the right index finger has been found to be larger in blind subjects who use braille than in sighted individuals.  Similarly, cab drivers in London who navigate the twisting streets of the city, have a larger hippocampus, which is involved in spatial navigation, than predefined route bus drivers. Hence experience changes size, activity, and connectivity of the brain. These changes in the brain are called neuroplasticity.

 

Over the last decade neuroscience has studied the effects of contemplative practices on the brain and has demonstrated that these practices produce neuroplastic changes in widespread areas. Indeed, mindfulness practices have been shown to not only alter how we think and feel but also to alter the nervous system, producing changes in the size, activity, and connectivity of specific structures and systems in the nervous system. Depression has been shown to also involve changes to the nervous system and is significantly improved by mindfulness practices. As a result of mindfulness practices’ ability to alter the brain and relieve depression, these practices have been incorporated into various psychotherapies for depression.

 

Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression. It has been shown to be remarkably effective. Putting all these pieces together, it would seem likely that MBCT relieves depression by altering neural systems. In today’s Research News article “Multi-dimensional modulations of α and γ cortical dynamics following mindfulness-based cognitive therapy in Major Depressive Disorder”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1184978338192757/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454126/

Schoenberg and Speckens investigated changes in brain activity produced by MBCT using sophisticated techniques to explore the electrical activity that can be recorded from various regions of the scalp (Electroencephalogram, EEG). They compared patients with major depressive disorder who were randomly assigned to receive 8-weeks of group Mindfulness Based Cognitive Therapy (MBCT) or treatment as usual, waitlist control. They found that MBCT treatment produced clinically significant improvements in depressive symptoms, self-compassion, over identification with painful thoughts and feelings, and mindfulness. This is not surprising, and replicates the well-established finding that MBCT is highly effective in treating depression.

 

They recorded the EEG of both groups while they performed a Go/NoGo task. Performance on this task has been shown to be deficient in depressed patients and indicates deficient executive function. They found that MBCT significantly downregulated α and γ power in the electrical activity of the brain. This indicates that there was and increase the excitability of the cerebral cortex. This is generally associated with greater positive mood and decreased negative emotions. This suggests that MBCT may relive depression by its effects on the neural systems underlying the depressed mood.

 

They also found an enhancement of the α-desynchronisation occurring in response to the Go/NoGo task when negative material was presented, but decreased α-desynchronisation when positive material was presented. This suggests that MBCT activates the neural networks underlying positive emotion. These are the systems that are usually relatively inactive in depression. This again suggests that MBCT may relieve depression by enhancing the activity of neural systems responsible for positive mood, thus working in opposition to the negative mood so characteristic of depression.

 

Finally, they found that MBCT increased intra-hemispheric α-coherence of the fronto-parietal circuit. This coherence has been shown to be related to improved attention and reduced mind wandering. In depression, mind wandering is highly related to rumination which tends to reinforce and support the depressed state. This suggests that MBCT may relive depression by enhancing the coherence of neural systems responsible for attention, thus inhibiting the mind wandering and rumination so characteristic of depression.

 

Hence the present study found evidence for changed electrical dynamics in the cortex of depressed patients following Mindfulness Based Cognitive Therapy (MBCT). The changes that were observed reflect changed processing of emotional information and attention, such that positive mood was enhanced, negative mood was reduced, and mind wandering and rumination decreased. All of these processes tend to counteract depression and may at least in part be responsible for the effectiveness of MBCT in treating depression.

 

So, change brain activity in depression with mindfulness.

 

“Being in the present moment, accepting what is, without wanting to change or interpret it, will greatly enhance emotional well-being, leading to healthier thinking patterns that will touch and better every other aspects of your life.” – Jonathan Banks

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Better Measurement of Mindfulness, Anxiety, and Depression

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By John M. de Castro, Ph.D.

 

“Thus, differing assessments may support implicitly distinct theoretical positions with respect to operationalizing mind- fulness. . . . researchers must be well informed and intentional in their selection of assessment tools because the breadth of currently available assessments provides researchers with a variety of measures, each with specific strengths and weaknesses. Not surprisingly, the various measures resulting from the diverse operational definitions of mindfulness have, at times, been found to be uncorrelated or only modestly associated, providing further evidence of confusion within the mindfulness literature.” – Adam Hanley

 

A prerequisite in science is that in order to study something you have to be able to measure it. With many concepts such as mindfulness, depression, and anxiety that reflect subjective states, there are currently no objective means to measure them. Measurement then falls to some kind of after the fact test or to a self-report. Traditionally, these variables have been measured with paper and pencil psychometric tests, such as the Cognitive Affective Mindfulness Scale-Revised, the Beck Depression Inventory, or the Profile of Mood States. They ask the participant to answer the question in regard to how they generally feel. These forms are filled out before and again after an intervention to assess the effect of the intervention on these subjective states.

 

With the advent of smart phones, a different kind of assessment method has emerged and is gaining greater popularity. It is sometimes called ecological momentary assessment (EMA). Individuals receive messages on their smart phones periodically asking them to answer questions about their state at the present moment. This can be done on multiple, somewhat randomly selected, occasions over the day or longer. It provides a measure that doesn’t require the participant to estimate how they feel in general, but rather uses an average of measures provided by the participant at various times.

 

In today’s Research News article “Ecological momentary assessment versus standard assessment instruments for measuring mindfulness, depressed mood, and anxiety among older adults”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1184314174925840/?type=3&theater

Moore and colleagues recruited elderly (over 65 years of age) participants with clinically significant anxiety distress. They compared the results for participants’ levels of mindfulness, depression, and anxiety measured either by traditional paper and pencil measures of how they were in general to those measured with an ecological momentary assessment (EMA) using smart phones. To obtain the EMA measures participants were sampled 3 times per day for ten days. The participants were randomly assigned to receive Mindfulness Based Stress Reduction (MBSR) program or a health education program. They were compared both before and after the interventions with both the traditional and EMA measurements.

 

Mindfulness Based Stress Reduction (MBSR) involves training in meditation, body scan, and yoga. It has been shown previously to increase mindfulness, and to decrease depression and anxiety levels in normal individuals and those with anxiety disorders, including the elderly. Moore and colleagues found in their study that on average both measures showed an increase in mindfulness and decreases in depression and anxiety, but, the effects were only statistically significant for ecological momentary assessment (EMA) and not for the traditional paper and pencil measures. These results suggested that EMA measurement in more sensitive and less unstable than traditional measures. To further document this, they calculated the number of participants that would be needed to show a statistically significant effects for the two measurement types and found that EMA measures required nearly half as many participants as the traditional measures. Hence, they found that EMA measure are substantially more sensitive and is capable of detecting differences with fewer participants.

 

These results indicate that ecological momentary assessment (EMA) is a better way to assess the states of research participants. Obtaining measures at a variety of points in time appears to produce more accurate results than asking the participant to estimate their overall states. This makes sense that actual measures are superior to participant estimates. The EMA technique is more expensive, takes more time and effort, and is more intrusive into the daily lives of the participants, but may be worth it for the improved accuracy and sensitivity.

 

“If you’ve ever struggled with depression, take heart. Mindfulness, a simple yet powerful way of paying attention to your most difficult emotions and life experiences, can help you break the cycle of chronic unhappiness once and for all.” – Mark Williams

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Improve Psychological and Physical Effects of HIV with Yoga

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By John M. de Castro, Ph.D.

 

“Yoga is not just about the physical side, it’s also about the mind-body connection. I think having that awareness and accepting their condition can help them when they go out into the world, and lift up their self-esteem. Life is fast – yoga can help them be calm and still.” – Surang Sengsamran

 

HIV is a virus that gradually attacks the immune system. It destroys a type of white blood cell called a T-helper cell (CD4 Cell). This isn’t a problem unto itself, but the immune system is our body’s natural defense against illness. Hence, HIV infection makes it harder to combat other infections and diseases. If HIV is untreated, these secondary infections produce chronic illness and eventually death. It is important, then, in treating HIV infection to strengthen the immune system and increase the levels of CD4 in the blood to fight off disease.

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20 year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Hence, patients with HIV infection, even when controlled with drugs, have a reduction in their quality of life.  There is thus a need to find methods to improve the quality of life in people who are living with HIV infection.

 

Mindfulness has been shown to strengthen the immune system. It also improve psychological and physical well-being in people suffering from a wide range of disorders including depression and anxiety. It has also been shown that mindfulness is associated with psychological well-being and lower depression in patients with HIV infection. Integrated Yoga is a contemplative practice that includes postures, breathing practices, relaxation techniques, and meditation. It has been shown to increase mindfulness, and reduce anxiety and depression. So, it would stand to reason that Integrated Yoga would be beneficial for people who are living with HIV infection.

 

In today’s Research News article “Effect of Integrated Yoga (IY) on psychological states and CD4 counts of HIV-1 infected patients: A randomized controlled pilot study”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1183625434994714/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728960/

Naoroibam and colleagues randomly assigned patients with HIV infection to either a one-hour per day, six-days per week Integrated Yoga practice for one-month or to a treatment as usual condition. Compared to before treatment and the control group, they found that the Integrated Yoga practice produced a significant reduction in anxiety and depression levels and an increase in T-helper cell (CD4 Cell) counts in the blood. It should be kept in mind that there was not an active control condition. So, it is unclear if the effectiveness of Integrated Yoga practice was due to exercise effects or perhaps to expectancy effects, researcher bias effects, etc. It will remain for future research to sort out exactly what is responsible to the improvement in the HIV patients.

 

Regardless, these are exciting and potentially important results suggesting that Integrated Yoga practice may not only improve the psychological well-being of HIV infected patients but also strengthen the immune system. This would make them better able to combat other infections and diseases.

 

So, improve psychological and physical effects of HIV with yoga.

 

“As you become more adept at yoga, you learn which poses can help you, depending on how you are feeling physically. There are certain poses that assist in relieving fatigue, diarrhea, anxiety, depression. You do learn about the nature of self, but you also learn that so much is beyond your control. It helps you realize, somehow, to trust in a higher being.” – Steve McCeney

 

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/

 

Improve Psychological Health of Veterans with a Mantra

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Improve Psychological Health of Veterans with a Mantra

 

By John M. de Castro, Ph.D.

 

“Asking for clarity provides a way to begin to see a path out of the pain of personal issues. With spiritual support the pain begins to be released, the path becomes clearer and the next step to create the rest of life begins to emerge.” – The Merritt Center

 

Alternative and Complementary techniques have been growing in acceptance and use over the last couple of decades. With good reason. They have been found to be beneficial for physical and mental health. Contemplative practices have been shown to improve health and well-being. These include mindfulness practices, meditation, yoga, mindful movement practices such as tai chi and qigong, and spiritual practices such as contemplative prayer. One ancient practice that is again receiving acceptance and use is mantra practice.

 

In today’s Research News article “Multi-site evaluation of a complementary, spiritually-based intervention for Veterans: The Mantram Repetition Program”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1182903115066946/?type=3&theater

Butner and colleagues investigate the effectiveness of a form of mantra practice, Mantram Repetition Practice (MRP) on the mindfulness, mental health, and spirituality of veterans. The MRP involves the repetition of a sacred word or phrase over and over again to slow the individual down and produce one-pointed attention. It is effectively a mindfulness meditation practice, except that there are no formal practice periods. The participant is trained to engage in MRP during their daily activities, periodically and as needed, particularly during times of confusion and stress. The individual selects a sacred word or phrase for use in MRP from a list that have particular meaning to them and within their preferred religious practice. Typical Christian words and phrases are “My God and My All”, “Jesus, Jesus”, “Son of God”, “Hail Mary”, “Mother of Jesus”, “Lord Jesus Christ”, “Son of God, have mercy on me.”

 

Butner and colleagues recruited veterans and measured mindfulness, physical and mental health, and spirituality before and after an 8-week Mantram Repetition Program (MRP) training. The veterans attended weekly training sessions, were encouraged to do homework and to use the MRP during their daily lives. Typical times were while waiting, doing mechanical tasks such as doing dishes, exercising, when encountering annoying situations, while eating, before bed, and to manage unwanted emotions. They found that after 8-weeks of MRP training and practice the veterans demonstrated significantly higher mindfulness and spirituality including greater peace, more meaning in life, and greater faith. After training the veterans also had significant reductions in psychological distress, including reduced somatization, depression and anxiety.

 

It should be noted that there was not an active control group. Improvement was documented by comparing before to after training scores. Because of the lack of active control, there are many confounding, alternative, explanations for the findings. These include participant expectancy effects, experimenter bias effects, simple improvement over time, occurrences between the beginning and end of the treatment period, etc. The results clearly demonstrate that the veterans improved substantially over the 8-weeks. It will remain for future research to verify that it was the Mantram Repetition Practice (MRP) and not a confounding variable that was responsible for the changes.

 

These caveats notwithstanding, the finding for MRP are compatible with those produced by other mindfulness programs with the exception of increased spirituality. It is possible that MRP produces its beneficial effects due to its development of mindfulness. Alternatively, spirituality, by itself, has been shown to be related to better physical and psychological health. So, MRP may be effective due to its improvement of spirituality in the veterans. It may also be that the combination of increased mindfulness and increased spirituality improves effectiveness or that the two have additive effects.

 

So, improve psychological health of veterans with a mantra.

 

“The veterans experiences with spirituality were real and unique, significantly contributing to growth. They needed the inclusion of Christian spirituality as part of their process in posttraumatic growth, and it was the key element in them moving forward.” – Sharon Flowers

 

CMCS – Center for Mindfulness and Contemplative Studies

Promote Physical and Mental Well-Being with Tai Chi

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By John M. de Castro, Ph.D.

 

“Tai Chi exercise had positive effects on the self-assessed physical and mental health of college students. Scores on the mental health dimension appeared to be particularly sensitive to change. Colleges/universities might consider offering Tai Chi as a component of their ongoing physical activity programs available to students.” – Y. T. Wang

 

Many people have fond memories of their college years. It is likely, however, that they forgot about the stress and angst of those years. The truth is that college is generally very stressful for most students, from the uncertainty of freshman year, to the social stresses of emerging adulthood, to the anxiety of launching into a career after senior year. Evidence for the difficulties of these years can be found in college counseling centers which are swamped with troubled students. In fact, it’s been estimated that half of all college students report significant levels of anxiety and depression.

 

Being able to perform at an optimum level is important in college. It would be very helpful if a

safe and effective way could be found to reduce stress, depression and anxiety in college students. Mindfulness training has been shown to reduce anxiety, stress, and depression . So, mindfulness training would appear to be well suited to deal with the problems of college students. The ancient eastern practice of mindful movement Tai Chi has been shown to reduce stress, depression, and anxiety. Hence, it would make sense to investigate whether Tai Chi practice might be effective for improving college student angst.

 

In today’s Research News article “A systematic review of the health benefits of Tai Chi for students in higher education”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1180406471983277/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733099/

Webster and colleagues review the published literature on the effectiveness of Tai Chi practice in improving college student physical and psychological states. They found that that the preponderance of evidence in the literature reported that Tai Chi practice significantly improved muscular flexibility. But the most interesting effects were in the psychological domain with Tai Chi practice significantly reducing depression, anxiety, symptoms of compulsion, somatization symptoms, hostility, and symptoms of phobia, and improved interpersonal sensitivity.

 

Hence, the published scientific literature suggests that Tai Chi practice can be of significant benefit for college students, improving them physically and improving their psychological well-being. Tai Chi practice is a gentle mindful movement practice. It is safe, having few if any adverse consequences, and effective with college students. This suggests that the engagement in Tai Chi practice should be encouraged in college promoting the physical and mental well-being of the students.

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“Of all the exercises, I should say that T’ai Chi is the best. It can ward off disease, banish worry and tension, bring improved physical health and prolong life. It is a good hobby for your whole life, the older you are, the better. It is suitable for everyone – the weak, the sick, the aged, children, the disabled and blind. It is also an economical exercise. As long as one has three square feet of space, one can take a trip to paradise and stay there to enjoy life for thirty minutes without spending a single cent.” ~T.T. Liang

 

CMCS – Center for Mindfulness and Contemplative Studies