Reduce Depression After Stillbirth with Yoga

September 12, 2020 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Bereaved mothers with stillbirth (death at >20 weeks of gestation) have more than a 6-fold higher risk for Post Traumatic Stress Disorder (PTSD) compared to mothers after live birth. . . . Non-pharmacological approaches, such as yoga, may be an alternative option for bereaved women with stillbirth.” – Jennifer Huberty

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 with 7%-8% of the population developing Post-Traumatic Stress Disorder (PTSD). It involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback.

Having a stillbirth is a traumatic event for young women. It inevitably produces profound depression, grief, and symptoms of PTSD. Obviously, this is a troubling problem that needs to be addressed. There are a number of therapies that have been developed to treat depression, grief and PTSD. One of which, mindfulness training has been found to be particularly effective for depression, PTSD symptoms, and grief. Yoga practice has also been found to reduce depression and PTSD symptoms. There is, however, no studies to date on the effectiveness of yoga practice to help alleviate the trauma produced by stillbirth.

In today’s Research News article “Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275350/) Huberty and colleagues recruited women who had experienced stillbirth within the last 2 years and randomly assigned them to receive 12 weeks of either low dose Hatha yoga (60 minutes per week), moderate dose Hatha yoga (150 minutes per week), or stretching and toning practice (60 minutes per week). All practice was led by online videos. They were measured before and after training and 8 weeks later for acceptability and demand for the program, PTSD symptoms, anxiety, depression, grief, self-compassion, emotion regulation, mindfulness, and sleep quality.

They found that PTSD symptoms decreased significantly over the measurement period with a 43% and 56% decrease for the low and moderate yoga groups and a 22% decrease for the stretching and toning group. But there were no significant differences between groups. On the other hand, in comparison to the stretching and toning group, both of the yoga groups had significant decreases in depression and grief. Unfortunately, the low dose yoga group only practiced on the average for 44 minutes per week and the high dose yoga only practiced for 77 minutes per week. This was well below the desired amount of practice.

The lack of a significant difference between the yoga and control groups was disappointing. Previous research has demonstrated that yoga practice reduces PTSD symptoms. It is possible that attempting to teach yoga remotely, online, to participants who are depressed simply may not be an effective way to encourage practice. Depressed patients lack motivation and it is possible that they need the encouragement of a group and an instructor to motivate their participation. Future research should employ traditional in person yoga classes for the treatment of women who had stillbirths.

Nevertheless, the yoga practice, even though it was below the dose desired, did significantly reduce depression. This corroborates previous findings that yoga practice is effective in treating a variety of forms of depression and suggests that it is also effective in treating depression emanating from stillbirth. Perhaps in person yoga classes may potentiate the effects on PTSD and other symptoms in women who had stillbirths.

So, reduce depression after stillbirth with yoga.

“a trauma-focused hatha yoga program may be a helpful adjunctive treatment for chronic PTSD.” – Sarah Krill Williston

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Huberty, J., Sullivan, M., Green, J., Kurka, J., Leiferman, J., Gold, K., & Cacciatore, J. (2020). Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial. BMC complementary medicine and therapies, 20(1), 173. https://doi.org/10.1186/s12906-020-02926-3

Abstract

Background

About 1 in every 150 pregnancies end in stillbirth. Consequences include symptoms of post traumatic stress disorder (PTSD), depression, and anxiety. Yoga has been used to treat PTSD in other populations and may improve health outcomes for stillbirth mothers. The purpose of this study was to determine: (a) feasibility of a 12-week home-based, online yoga intervention with varying doses; (b) acceptability of a “stretch and tone” control group; and (c) preliminary efficacy of the intervention on reducing symptoms of PTSD, anxiety, depression, perinatal grief, self-compassion, emotional regulation, mindfulness, sleep quality, and subjective health.

Methods

Participants (N = 90) were recruited nationally and randomized into one of three groups for yoga or exercise (low dose (LD), 60 min per week; moderate dose (MD), 150 min per week; and stretch-and-tone control group (STC)). Baseline and post-intervention surveys measured main outcomes (listed above). Frequency analyses were used to determine feasibility. Repeated measures ANCOVA were used to determine preliminary efficacy. Multiple regression analyses were used to determine a dose-response relationship between minutes of yoga and each outcome variable.

Results

Over half of participants completed the intervention (n = 48/90). Benchmarks (≥70% reported > 75% satisfaction) were met in each group for satisfaction and enjoyment. Participants meeting benchmarks (completing > 90% of prescribed minutes 9/12 weeks) for LD and MD groups were 44% (n = 8/18) and 6% (n = 1/16), respectively. LD and MD groups averaged 44.0 and 77.3 min per week of yoga, respectively. The MD group reported that 150 prescribed minutes per week of yoga was too much. There were significant decreases in PTSD and depression, and improvements in self-rated health at post-intervention for both intervention groups. There was a significant difference in depression scores (p = .036) and grief intensity (p = .009) between the MD and STC groups. PTSD showed non-significant decreases of 43% and 56% at post-intervention in LD and MD groups, respectively (22% decrease in control).

Conclusions

This was the first study to determine the feasibility and preliminary efficacy of an online yoga intervention for women after stillbirth. Future research warrants a randomized controlled trial.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275350/

Improve Fertility with Mindfulness

August 31, 2020April 28, 2022 psyjdc Leave a comment

Improve Fertility with Mindfulness

By John M. de Castro, Ph.D.

“those who participate in a mind-body wellness program are 32% more likely to become pregnant!” – Michelle Anne

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women are infertile. Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives. Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack.

Mindfulness training been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. This is especially true for Mindfulness-Based Cognitive Therapy (MBCT) which was specifically developed to treat depression. MBCT has been shown to be effective in treating infertility. At this point it’s useful to step back and summarize what has been learned about mindfulness training and infertility.

In today’s Research News article “Application of Mindfulness-Based Psychological Interventions in Infertility.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295259/), Patel and colleagues review and summarize the published scientific research of the effectiveness of mindfulness training in treating infertility. They identified 9 published research studies.

They report that the research found that mindfulness training decreases anxiety, depression, stress, and anger, and increases well-being and quality of life of infertile women. These enhance the self-efficacy of women coping with infertility. Mindfulness training also has been found to reduce emotional stress and stress hormones and improve sleep and immune function all of which are known to play an important role in infertility. These all lead to increased conception rates.

The psychological and emotional issues that result from infertility produce a negative spiral, where infertility increases emotional dysfunction, which in turn lessens the likelihood of conception, which increases emotionality and so on. Mindfulness training appears to interrupt this cycle by improving the psychological and physical well-being of infertile women. This allows the women to relax and better cope with the issues surrounding infertility. This in turn improves their likelihood of conception. Hence, mindfulness training should be recommended for infertile women.

So, improve fertility with mindfulness.

“mindfulness becomes the perfect antidote for the paradoxical land mines infertility presents. Mindfulness starts from the perspective that you are whole and complete already, regardless of flaws or imperfections. It is based on the concept of original goodness: your essential nature is good and pure. Proceeding from this vantage point gives you freedom from the bondage of inadequacy and insecurity.” – Janetti Marotta

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Patel, A., Sharma, P., & Kumar, P. (2020). Application of Mindfulness-Based Psychological Interventions in Infertility. Journal of Human Reproductive Sciences, 13(1), 3–21. https://doi.org/10.4103/jhrs.JHRS_51_19

Abstract

Living mindfully helps one gain a deeper understanding into realities of life. It enables people to witness suffering, desire, attachments, and impermanence without any fear, anxiety, anger, or despair. This is considered the hallmark of true psychological insight. As a skill, mindfulness can be inculcated by anyone. Mindfulness helps in attending, getting aware and understanding experiences in a compassion and open-minded way. Research suggests that applying mindfulness in daily life has been known to tame our emotional mind and enabled people to perceive things “as they are” without ascribing expectations, judgments, cynicism, or apprehensions to them. This review unravels the therapeutic power of mindfulness meditation in the context of infertility distress. It serves to integrate the evidence on the effectiveness of mindfulness-based psychological interventions to improve the emotional well-being and biological outcomes in Infertility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295259/

Reduce Anxiety and Improve Self-Efficacy in Pregnancy with Mindfulness

August 1, 2020 psyjdc Leave a comment

Reduce Anxiety and Improve Self-Efficacy in Pregnancy with Mindfulness

By John M. de Castro, Ph.D.

“Mindfulness practices during pregnancy has several benefits: better manage chronic pain, depression, and anxiety, reduce fears about childbirth, reduce fears surrounding your pregnancy and parenting, increase confidence for birth and parenting, reduce perception of pain in birth.” – Cara Terreri

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

It is clear that there is a need for methods to treat depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy.

In today’s Research News article “The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177577/), Zarenejad and colleagues recruited women pregnant with their first child between 24 and 36 weeks of pregnancy. They were randomly assigned to either usual care or to receive 6 weeks of twice a week for 1-hour group mindfulness training based upon the Mindfulness-Based Stress Reduction (MBSR) program. The training employs meditation, body scan, yoga, discussions, and home practice. They were measured before and after training and 1 month later for mindfulness, pregnancy related anxiety, and self-efficacy.

They found that in comparison to baseline and the usual care group, the women who received mindfulness training had significant increases in mindfulness and significant decreases in pregnancy related anxiety immediately after training and one month after training where there was also a significant increase in self-eficacy..

Mindfulness training has been repeatedly demonstrated in prior research to decrease anxiety and increase self-efficacy in a wide range of healthy and ill populations. The present study demonstrates that this training has similar effects with late-term pregnant women in Iran. The increase in self-efficacy suggests that mindfulness training improves the women’s beliefs that they can deal with their situation and the reduction in anxiety suggests that they can approach delivery with greater levels of confidence and relaxation. This should reduce the stress of delivery and increase the likelihood of a satisfactory and health outcome.

So, reduce anxiety and improve self-efficacy in pregnancy with mindfulness.

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

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Zarenejad, M., Yazdkhasti, M., Rahimzadeh, M., Mehdizadeh Tourzani, Z., & Esmaelzadeh-Saeieh, S. (2020). The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial. Brain and behavior, 10(4), e01561. https://doi.org/10.1002/brb3.1561

Abstract

Objective

The aim of the study was to assess the effect of mindfulness‐based stress reduction (MBSR) on anxiety and self‐efficacy in coping with childbirth.

Material and Methods

This randomized controlled trial was conducted on 70 pregnant women in Abyek city of Qazvin province in Iran. The convenient sampling method was recruited. Samples were assigned to control and intervention groups using random blocks. In addition to routine care, individuals in the intervention group received 6 MBSR training sessions. The data gathering questionnaire in this study included mindfulness, Pregnancy‐Related Anxiety Questionnaire, and self‐efficacy in coping with childbirth questionnaire.

Results

There was no statistically significant difference between the demographic characteristics in the control and intervention groups. The results of the analysis of variance (ANOVA) with repeated measures indicated the effect of time on the change in the total score of anxiety in the intervention group (p = .001). There was a significant difference between the two groups (p = .001). Also, the results of ANOVA with repeated measures showed that time had no impact on the score of self‐efficacy in delivery coping (p = 0/1) and that there was no significant difference between the two groups in this respect (p = .6).

Conclusion

The result of this study showed that mindfulness reduces anxiety of pregnant mothers, and it is suggested that mindfulness programs be educated for healthcare providers and pregnant mothers to reduce maternal anxiety and improve pregnancy outcomes and delivery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177577/

Improve Depression During the Perinatal Period with Mindfulness

May 20, 2020 psyjdc Leave a comment

Improve Depression During the Perinatal Period with Mindfulness

By John M. de Castro, Ph.D.

“Pregnancy is a challenging terrain for everyone to navigate. And if you are entering that space with some history of depression, it can be particularly challenging.” – Sona Dimidjian

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Hence, it is clear that there is a need for methods to treat depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy.

Mindfulness practices have been found to help with coping with loss and its consequent grief. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms.

In today’s Research News article “Mindfulness-Based Cognitive Therapy for Perinatal Women with Depression or Bipolar Spectrum Disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021274/), Miklowitz and colleagues recruited women with major depressive or bipolar disorders who were either pregnant, within 1 year postpartum, or trying to get pregnant. They were provided with weekly 2-hour sessions for 8 weeks of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after treatment and at 1 and 6 months later for psychological symptom severity, reoccurrence of major depression, mindfulness, and acceptability of treatment.

They found that in comparison to baseline, after Mindfulness-Based Cognitive Therapy (MBCT) there were significant reduction in depression and increases in mindfulness. The women on average moved from mildly to minimally depressed categories. These improvements were maintained 1 and 6 months later. The women who had major depressive disorder had significantly greater improvements in depression than the women with bipolar disorder.

These results suggest that Mindfulness-Based Cognitive Therapy (MBCT) is an effective treatment for depression in perinatal women with lasting benefits. This should help relieve the women’s suffering and help them to be better mothers to their children. MBCT has been shown to be effective for a wide variety of patients with depression. The present study increases the types of depression that are known to respond positively to MBCT.

So, improve depression during the perinatal period with mindfulness.

“mindfulness training could help improve mothers’ experience of labor and reduce the likelihood of postpartum depression.” – Jenn Knudsen

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Miklowitz, D. J., Semple, R. J., Hauser, M., Elkun, D., Weintraub, M. J., & Dimidjian, S. (2015). Mindfulness-Based Cognitive Therapy for Perinatal Women with Depression or Bipolar Spectrum Disorder. Cognitive therapy and research, 39(5), 590–600. https://doi.org/10.1007/s10608-015-9681-9

Abstract

The perinatal period is a high-risk time for mood deterioration among women vulnerable to depression. This study examined feasibility, acceptability, and improvement associated with mindfulness-based cognitive therapy (MBCT) in perinatal women with major depressive disorder (MDD) or bipolar spectrum disorder (BSD). Following a diagnostic evaluation, 39 perinatal women with a lifetime history of MDD (n = 27) or BSD (n = 12) enrolled in an 8-week program of MBCT classes (2 h each) that incorporated meditation, yoga, and mood regulation strategies. Participants were pregnant (n = 12), planning pregnancy (n = 11), or up to 1-year postpartum (n = 16). Participants were self-referred and most had subthreshold mood symptoms. Assessments of depression, (hypo)mania, and anxiety were obtained by interview and self-report at baseline, post-treatment and at 1- and 6-month post-treatment. Women with a history of MDD were more likely to complete the classes than women with BSD. Of 32 women who completed the classes, 7 (21.9 %) had a major depressive episode during the 6-month post-treatment follow-up. On average, participants with MDD reported improvements in depression from pre- to post-treatment. Mood improvement was not observed in the BSD group. In the full sample, improvements in depression symptoms across time points were associated with increasing mindful tendency scores. This study was limited by its uncontrolled design, heterogeneous sample, and questionnaire-based assessment of mindfulness skills. MBCT may be an important component of care for perinatal women with histories of major depression. Its applicability to perinatal women with BSD is unclear.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021274/

Improve the Psychological and Physical Health of Pregnant Low-Income Women with Mindfulness

March 14, 2020 psyjdc Leave a comment

Improve the Psychological and Physical Health of Pregnant Low-Income Women with Mindfulness

By John M. de Castro, Ph.D.

“in pregnant women at high risk for excessive weight gain, it is both feasible and effective to use mindfulness strategies taught in a group format. Further, increases in certain mindfulness skills may help with better management of stress and overeating during pregnancy.” – Thomas Vieten

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. Pregnancy produces vast changes in the woman’s life, her body, her emotions, and her family. These changes may well be desired and welcomed, but they produce stress. Indeed, stress is a common experience in pregnancy. But it must be controlled. Too much stress can produce sleeping problems, headaches, loss of appetite or its opposite, overeating. If the levels of stress are high and prolonged it can produce health problems such as hypertension (high blood pressure) and heart disease in the mother. It can also make it more likely that the baby will be born prematurely or with a low birthweight, both of which are indicators of health problems for the infant and in the later child’s life. These stresses are magnified in low-income women.

So, it is important to either control stress during pregnancy or find ways to better cope with it. Mindfulness training has been shown to reduce the individual’s psychological and physiological responses to stress. Hence, mindfulness training may be a safe and effective method to assist the pregnant woman in coping with the stresses of pregnancy. Low-income women are particularly vulnerable to these stresses and have a high rate of rapid weight gain and metabolic syndrome during pregnancy. Indeed, mindfulness training appears to be effective in improving the mental and physical health of low-income individuals. Hence, it is important to study if mindfulness training can improve the health of low-income women.

In today’s Research News article “Effects of a Mindfulness-Based Intervention on Distress, Weight Gain, and Glucose Control for Pregnant Low-Income Women: A Quasi-Experimental Trial Using the ORBIT Model.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785577/), Epel and colleagues recruited low-income overweight and obese, pregnant women who were in their12th to 19th week of gestation. They were provided with a 2 hour once a week for 8 weeks program of a Mindful Moms training program. This included mindful movements and mindfulness practices and discussions of stress reduction, mindful eating, and nutrition. They were compared to a comparable group who simply continued with their usual treatments. They were measured for gestational weight gain, postpartum weight retention, and before and after the intervention for physical activity perceived stress, depression, pregnancy related anxiety, acceptance of negative experiences, eating behaviors, eating addiction, and mindfulness. They also received a glucose tolerance test.

They found that in comparison to baseline the group that received mindfulness training had significant reductions in perceived stress, depression, food addiction, emotional eating, external eating and significant increases in acceptance of negative experiences, glucose tolerance, and physical activity. Both groups gained excessive weight during pregnancy and retained it postpartum with no significant differences.

Conclusions must be tempered with the knowledge that the women were not randomly assigned to intervention and control conditions, rather they were assigned based upon whether their schedules allowed participation in the mindfulness training classes. Hence, there may have been systematic differences between the groups at the outset.

Nevertheless, the results are both disappointing and encouraging. They were disappointing in that the intervention did not alter the high weight gains during pregnancy or their retention postpartum even though there were improvements in their eating behaviors, physical activity, and glucose tolerance. These women were overweight and obese at the beginning, so the excess weight gains are unwanted and may further damage their health and that of their offspring.

The results, however, are encouraging in that they suggest that mindfulness training may improve the psychological and physical health of these women. Having low-income provides additional difficulty and stress on these pregnant women. So, the ability of mindfulness training to reduce the stress and improve their psychological health is welcome. The improvements in physical activity and glucose tolerance may signal improvements in the overall metabolic health of these women. Follow ups of these women need to be pursued to determine if there were significant impacts of the training on the infants and their development.

So, improve the psychological and physical health of pregnant low-income women with mindfulness.

“women in the mindfulness group had lower stress levels, higher mindfulness measures, and lower weight gains during pregnancy.” Elissa Epel

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Epel, E., Laraia, B., Coleman-Phox, K., Leung, C., Vieten, C., Mellin, L., … Adler, N. (2019). Effects of a Mindfulness-Based Intervention on Distress, Weight Gain, and Glucose Control for Pregnant Low-Income Women: A Quasi-Experimental Trial Using the ORBIT Model. International journal of behavioral medicine, 26(5), 461–473. doi:10.1007/s12529-019-09779-2

Abstract

Background

Stress can lead to excessive weight gain. Mindfulness-based stress reduction that incorporates mindful eating shows promise for reducing stress, overeating, and improving glucose control. No interventions have tested mindfulness training with a focus on healthy eating and weight gain during pregnancy, a period of common excessive weight gain. Here, we test the effectiveness of such an intervention, the Mindful Moms Training (MMT), on perceived stress, eating behaviors, and gestational weight gain in a high-risk sample of low income women with overweight/obesity.

Method

We conducted a quasi-experimental study assigning 115 pregnant women to MMT for 8 weeks and comparing them to 105 sociodemographically and weight equivalent pregnant women receiving treatment as usual. Our main outcomes included weight gain (primary outcome), perceived stress, and depression.

Results

Women in MMT showed significant reductions in perceived stress (β = − 0.16) and depressive symptoms (β = − 0.21) compared to the treatment as usual (TAU) control group. Consistent with national norms, the majority of women (68%) gained excessive weight according to Institute of Medicine weight-gain categories, regardless of group. Slightly more women in the MMT group gained below the recommendation. Among secondary outcomes, women in MMT reported increased physical activity (β = 0.26) and had lower glucose post-oral glucose tolerance test (β = − 0.23), being 66% less likely to have impaired glucose tolerance, compared to the TAU group.

Conclusion

A short-term intervention led to significant improvements in stress, and showed promise for preventing glucose intolerance. However, the majority of women gained excessive weight. A longer more intensive intervention may be needed for this high-risk population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785577/

Better Mental Health During Pregnancy is Associated with Mindfulness

October 28, 2019 psyjdc Leave a comment

Better Mental Health During Pregnancy is Associated with Mindfulness

By John M. de Castro, Ph.D.

“mindfulness is a seriously beneficial practice during pregnancy, too? Simply tuning in and being aware can be a powerful tool to lessen stress, calm anxiety, and help you feel more connected during those long nine months.” – Carrie Murphy

In today’s Research News article “An investigation of dispositional mindfulness and mood during pregnancy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676599/), Krusche and colleagues recruited pregnant women and had them complete measures of mindfulness, anxiety, depression, perceived stress, pregnancy distress, worries about labor, prenatal distress, pregnancy related discomforts, and pregnancy expectancies.

They found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, perceived stress, worries about labor, pregnancy distress, prenatal distress, first and second trimester discomfort, and frequency and intensity of negative pregnancy experiences, and greater frequency and intensity of positive pregnancy experiences.

This study was correlational, so no conclusions can be reached about causation. But the results are striking that mindfulness is associated with better pregnancy related experiences, mood, and mental health. This portends well for the outcome of pregnancy and the health of the child. Future research should attempt to investigate the effects of mindfulness training during pregnancy on the mood, experiences, and mental health of the women.

So, better mental health during pregnancy is associated with mindfulness.

“cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up. . . it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Krusche, A., Crane, C., & Dymond, M. (2019). An investigation of dispositional mindfulness and mood during pregnancy. BMC pregnancy and childbirth, 19(1), 273. doi:10.1186/s12884-019-2416-2

Abstract

Background

Mindfulness courses are being offered to numerous groups and while a large body of research has investigated links between dispositional mindfulness and mood, few studies have reported this relationship during pregnancy. The aim of this study was to investigate this relationship in pregnant women to offer insight into whether an intervention which may plausibly increase dispositional mindfulness would be beneficial for this population.

Methods

A cross-sectional analysis was conducted to explore potential relationships between measures of mindfulness and general and pregnancy-specific mood. A sample of pregnant women (n = 363) was recruited using online advertising and community-based recruitment and asked to complete a number of questionnaires online.

Results

Overall, higher levels of mindfulness were associated with improved levels of general and pregnancy-related mood in pregnant women. Controlling for general stress and anxiety, higher scores for mindfulness in (psychologically) healthy women were associated with lower levels of pregnancy-related depression, distress and labour worry but this relationship was not apparent in those with current mental health problems. In participants without children, higher mindfulness levels were related to lower levels of pregnancy-related distress.

Conclusions

These results suggest a promising relationship between dispositional mindfulness and mood though it varies depending on background and current problems. More research is needed, but this paper represents a first step in examining the potential of mindfulness courses for pregnant women. Increasing mindfulness, and therefore completing mindfulness-based courses, is potentially beneficial for improvements in mood during pregnancy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676599/

Improve Mental Health Postpartum with Perinatal Mindfulness Training

August 10, 2019 psyjdc Leave a comment

Improve Mental Health Postpartum with Perinatal Mindfulness Training

By John M. de Castro, Ph.D.

“the ideal treatment plan for perinatal depression and anxiety often includes mindfulness techniques. Exercises such as deep breathing, progressive muscle relaxation, and meditation, for example, have been shown to reduce blood pressure and promote recovery from many illnesses.” – Edith Gettes

The birth of a child is most often a joyous occasion. But often the joy turns to misery. Immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long-lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

Mindfulness training has been shown to improve anxiety and depression in general and to relieve maternal anxiety and depression during pregnancy. But it is not known if the effectiveness of mindfulness training during the perinatal period carries over to the postpartum period. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying depression. So, it would make sense to study the effectiveness of MBCT administered during the perinatal period on postpartum mental health issues.

In today’s Research News article “Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070304/), Luberto and colleagues recruited pregnant women (average of 15.5 weeks pregnant) and provide them with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training and 3 months postpartum for anxiety, depression, worry, mindfulness, self-compassion, meditation frequency, and home practice.

They found that after treatment there were significant increases in mindfulness and self-compassion and significant decreases in anxiety, depression, and worry. These improvements were maintained at 3-months postpartum except for depression that had a further significant decline. After the intervention 91% of the women continued to practice meditation and 65% continued practicing yoga. During the postpartum period 55% of the women continued to practice meditation and 25% continued practicing yoga. There were no significant differences in the outcomes for women who continued to practice versus those that didn’t.

These results are important in that they demonstrate that Mindfulness-Based Cognitive Therapy (MBCT) produces important benefits for the mental health of pregnant women that endure into the postpartum period. This is important as “baby blues” and postpartum depression are frequent and difficult consequences of childbirth. The findings suggest that MBCT training during pregnancy may help to prevent “baby blues” and postpartum depression. Hence, MBCT the produces lasting improvements in the psychological state of women during both the perinatal and postpartum periods.

So, improve mental health postpartum with perinatal mindfulness training.

“By paying attention, by being mindful, I was able to accept things that spun me out previously. I still had low points, but I was better equipped to manage and accept them as feelings and moments, and move on. . . . What I thought was caused by hormone fluctuations and “baby blues” was actually much more severe.” – Kristi Pahr

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Luberto, C. M., Park, E. R., & Goodman, J. H. (2018). Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women. Mindfulness, 9(3), 850–859. doi:10.1007/s12671-017-0825-8

Abstract

Anxiety is common during pregnancy and associated with poorer outcomes for mother and child. Our single-arm pilot study of an eight-week Mindfulness-Based Cognitive Therapy (MBCT) intervention for pregnant women with elevated anxiety showed significant pre- to post-intervention improvements in anxiety, depression, worry, mindfulness, and self-compassion. It remains unclear whether these improvements are maintained post-partum and whether amount of formal mindfulness practice is correlated with outcomes. The current study examined whether 1) improvements in psychosocial outcomes were maintained three months postpartum; 2) women were adherent to formal practice recommendations; and 3) amount of mindfulness practice was correlated with outcomes. Twenty-three pregnant women (Mage=33.5, SD=4.40; 75% White; 71% with Generalized Anxiety Disorder) completed home practice logs throughout the intervention, and self-report measures before and after the intervention and three months postpartum. Results indicated that previously reported post-intervention improvements in anxiety, worry, mindfulness, and self-compassion were maintained postpartum (p’s<.05), and reductions in depression further improved (p<.001). Participants were generally adherent to mindfulness practice recommendations during the intervention (54%-80% weekly adherence; M=17.31 total practice hours [SD=7.45]), and many continued practicing one-week post-intervention (91%) and postpartum (55%). Mindfulness practice during the intervention was not significantly correlated with any outcome at post-intervention or postpartum. Mindfulness practice postpartum was only marginally related to improved worry postpartum (p=.05). MBCT may be associated with maintained improvements in psychosocial outcomes for women during pregnancy and postpartum, but the role of mindfulness practice is unclear. Research using larger samples and randomized controlled designs is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070304/

Reduce Depression During and After Pregnancy with Mindfulness

February 6, 2018 psyjdc Leave a comment

Reduce Depression During and After Pregnancy with Mindfulness

By John M. de Castro, Ph.D.

“mindfulness practice, when attention increases in one area of life, the awareness expands in many other areas, as well. A mother who is able to care for and attend to her own vulnerabilities will have much more access to those very same skills as a parent.” – Sonya Dimidjian

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment. The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Hence, it is clear that there is a need for methods to treat depression during and after pregnancy.

Since, many drugs can affect the fetus, non-pharmacological treatments for depression are preferable. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. Mindfulness-Based Cognitive Therapy (MBCT) was specificly developed to treat depression and consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying depression. So, it would make sense to further study the effectiveness of MBCT for depression during the perinatal period.

In today’s Research News article “Staying Well during Pregnancy and the Postpartum: A Pilot Randomized Trial of Mindfulness Based Cognitive Therapy for the Prevention of Depressive Relapse/Recurrence.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718345/ ), Dimidjian and colleagues recruited pregnant women with Major Depressive Disorder and randomly assigned them to receive either treatment as usual or to Mindfulness-Based Cognitive Therapy (MBCT). MBCT was modified for pregnant women and administered for 2 hours, once a week, for 8 weeks and home practice was assigned. The women were measured for depression before and after treatment and at 1 and 6 months after birth.

In regards to depression, they found that relapse rates for depression over the 6-month follow-up period were significantly lower for the MBCT group; 18% vs. 50% for treatment as usual. In addition, the MBCT group had significantly lower levels of depression after treatment. Although the differences were not significant the MBCT group took fewer antidepressant medications and had fewer visits for therapy. A goal of this pilot research study was to assess the acceptability of the program and compliance with its requirements. They found that 89% completed the MBCT program and home practice occurred on over 70% of the available days. In addition, the women reported a high degree of satisfaction with the program.

These are impressive results for a pilot study and should provide the encouragement to perform a large randomized controlled clinical trial with an active control group. The results suggest that MBCT treatment is a safe and effective treatment for perinatal depression and has high acceptability and compliance among pregnant women. Hence it is a promising treatment for perinatal depression.

So, reduce depression during and after pregnancy with mindfulness.

“Not only does cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up—benefits that are well-documented among other groups of people—it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Dimidjian, S., Goodman, S. H., Felder, J., Gallop, R., Brown, A. P., & Beck, A. (2016). Staying Well during Pregnancy and the Postpartum: A Pilot Randomized Trial of Mindfulness Based Cognitive Therapy for the Prevention of Depressive Relapse/Recurrence. Journal of Consulting and Clinical Psychology, 84(2), 134–145. http://doi.org/10.1037/ccp0000068

Abstract

Objective

Clinical decision-making regarding the prevention of depression is complex for pregnant women with histories of depression and their healthcare providers. Pregnant women with histories of depression report preference for non-pharmacological care, but few evidence-based options exist. Mindfulness-based cognitive therapy has strong evidence in the prevention of depressive relapse/recurrence among general populations and indications of promise as adapted for perinatal depression (MBCT-PD). With a pilot randomized clinical trial, our aim was to evaluate treatment acceptability and efficacy of MBCT-PD relative to treatment as usual (TAU).

Methods

Pregnant adult women with depression histories were recruited from obstetrics clinics at two sites and randomized to MBCT-PD (N= 43) or TAU (N=43). Treatment acceptability was measured by assessing completion of sessions, at-home practice, and satisfaction. Clinical outcomes were interview-based depression relapse/recurrence status and self-reported depressive symptoms through 6-months postpartum.

Results

Consistent with predictions, MBCT-PD for at-risk pregnant women was acceptable based on rates of completion of sessions and at-home practice assignments, and satisfaction with services was significantly higher for MBCT-PD than TAU. Moreover, at-risk women randomly assigned to MBCT-PD reported significantly improved depressive outcomes compared to participants receiving TAU, including significantly lower rates of depressive relapse/recurrence and lower depressive symptom severity during the course of the study.

Conclusions

MBCT-PD is an acceptable and clinically beneficial program for pregnant women with histories of depression; teaching the skills and practices of mindfulness meditation and cognitive behavioral therapy during pregnancy may help to reduce the risk of depression during an important transition in women’s lives.

Public Health Significance Statement

This study’s findings support MBCT-PD as a viable non-pharmacological approach to preventing depressive relapse/recurrence among pregnant women with histories of depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718345/

Improve Mental Health During Pregnancy with Mindfulness

January 12, 2018 psyjdc Leave a comment

Improve Mental Health During Pregnancy with Mindfulness

By John M. de Castro, Ph.D.

In today’s Research News article “Mindfulness-Based Interventions During Pregnancy: a Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693962/ ), Dhillon and colleagues review, summarize, and perform a meta-analysis of 14 published controlled research studies of the effects of mindfulness training on the psychological health of the mother.

They found that the published research reports that mindfulness training during pregnancy produces significant reductions in anxiety, depression, and perceived stress, and increases in mindfulness. Hence, mindfulness training was found to significantly improve the psychological health of the pregnant women. Some studies identified similar trends but not significant differences and so there is some question as to the robustness of the effects. Further research is needed to verify these benefits.

It is well established that mindfulness training reduces anxiety, depression, and perceived stress in a wide array of healthy and ill individuals of a variety of ages. So, it is not surprising that mindfulness training has similar effects on pregnant women. But, that it does, is particularly important during pregnancy due to the consequences for the child and its development.

So, improve mental health during pregnancy with mindfulness.

“Practicing mindfulness during pregnancy and childbirth can bring great benefits, which will extend beyond the birth into the sometimes stressful, always profound and mostly joyful weeks and months of learning to care for our child. Mindfulness can be a source of strength and pleasure in our years as a family.“ – Daniel & Jannette

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Dhillon, A., Sparkes, E., & Duarte, R. V. (2017). Mindfulness-Based Interventions During Pregnancy: a Systematic Review and Meta-analysis. Mindfulness, 8(6), 1421–1437. http://doi.org/10.1007/s12671-017-0726-x

Abstract

This systematic review aims to assess the effect of mindfulness-based interventions carried out during pregnancy exploring mindfulness and mental health outcomes. A systematic review was conducted to appraise the current literature on the subject area. Inclusion and exclusion criteria were agreed and after reviewing titles, abstracts and full papers, 14 articles met the inclusion criteria and were included in the review. The quality of included articles was checked using the Quality Assessment Tool for Quantitative Studies. Pooled results of the randomised controlled trials (RCTs) reporting outcomes on anxiety, depression and perceived stress indicated no differences between the mindfulness intervention group and the control group. Pooled results of the non-RCTs reporting anxiety, depression and perceived stress showed a significant benefit for the mindfulness group. Mindfulness as an outcome was assessed in four RCTs for which the pooled results show a significant difference in favour of the mindfulness intervention when compared to a control group. The pooled results of the four non-RCTs also indicate a significant difference following mindfulness intervention. Results suggest that mindfulness-based interventions can be beneficial for outcomes such as anxiety, depression, perceived stress and levels of mindfulness during the perinatal period. Further research would be useful to explore if such benefits are sustained during the post-natal period.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693962/

Reduce Postpartum Depression with Mindfulness

December 21, 2017 psyjdc Leave a comment

Reduce Postpartum Depression with Mindfulness

By John M. de Castro, Ph.D.

“Interventions that bring a deeper sense of self-knowing and well-being to mothers allow them, in turn, to model this behavior for their children. We can’t possibly have the foresight to see how it ripples out from there, but we can be sure that it does.” – Heather Grimes

The birth of a child is most often a joyous occasion. But, often the joy turns to misery. Immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

Postpartum depression is treated much like depression in general with medications, psychotherapy, and support groups. But these methods often don’t work or have troublesome side effects. So, alternative treatments are needed. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of mindfulness training as a treatment for postpartum depression.

In today’s Research News article “The effectiveness of mindfulness training on reducing the symptoms of postpartum depression.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586989/, Sheydaei and colleagues recruited new mothers who exhibited symptoms of depression and randomly assigned them to receive either treatment as usual or an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). MBCT consists of mindfulness training and Cognitive Behavioral Therapy (CBT) to investigate and alter aberrant thought patterns underlying depression. MBCT was administered for 2 hours, once a week, for 8 weeks. The women were measured for depression before and after treatment.

They found that after treatment the control group showed no change in depression while, on the other hand, the women who received the MBCT program had a significant, 25%, reduction in depression. The conclusions from this study need to be tempered with the fact that the control condition did not have an active treatment. So, placebo effects, demand characteristics, experimenter bias, etc. could be alternative explanations. But, it has been well established that mindfulness training in general and MBCT in particular are effective in treating depression. So, it is likely that MBCT effectively reduced the depression in these women with newborn children. Hence, MBCT appears to be a safe and effective treatment for postpartum depression. Mindfulness training might be employed not only to treat postpartum depression but also as a preventative measure.

So, reduce postpartum depression with mindfulness.

“mothers in the mindfulness group seemed to have had a better psychological experience of labor compared to the control group. They reported feeling greater “self-efficacy” during childbirth (the sense that they were able to handle it rather than feeling afraid), and lower symptoms of depression after the workshop and several weeks after childbirth.” – Jenn Knudsen

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Sheydaei, H., Ghasemzadeh, A., Lashkari, A., & Kajani, P. G. (2017). The effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Electronic Physician, 9(7), 4753–4758. http://doi.org/10.19082/4753

Abstract

Background and Aim

Postpartum depression is one of the prevalent disorders among new mothers. The present research aimed to examine the effectiveness of mindfulness training on reducing the symptoms of postpartum depression.

Method

The present quasi-experimental research was conducted on 410 new mothers in Shahid Chamran Hospital, Tehran in 2014. Using the Beck Depression Inventory (BDI), Structured Clinical Interview and Psychological Clinical Diagnosis, 67 mothers were selected and then randomly divided into experimental and control groups, each of which with 32 applicants. Afterwards, the experimental group received mindfulness training for 8 sessions, each lasting for two hours while the control group received no training. The data were analyzed through descriptive statistics and Analysis of Covariance (ANCOVA) in SPSS, version 20.

Results

Results showed that based on Beck Inventory, the scores for the experimental group in post-test were significant (p<0.001), compared to those for the control group. Also, it was revealed that pre- and posttest mean scores for postpartum depression in the control group were 25.81 and 25.12 respectively while the scores for the experimental group were 24.75 and 18.5 respectively. Since the posttest mean score in the experimental group was lower than that in the pretest, it can be said that the treatment, i.e., mindfulness training, was effective in reducing depression symptoms in mothers.

Conclusion

Findings proved that mindfulness training was effective in reducing the symptoms of postpartum depression in new mothers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586989/