Mindfulness meditation reduces anxiety like antidepressants

New research reveals mindfulness meditation is as good at reducing anxiety as an antidepressant.

The JAMA Psychiatry study is the first to compare MBSR to Lexapro for anxiety disorders.

The study adds to the growing evidence that mindfulness is an effective treatment for anxiety.

“Our study shows that mindfulness-based stress reduction is an effective treatment for anxiety disorders,” said the study’s author, Dr. Elizabeth Hoge of Georgetown University Medical Center. “Clinicians, insurers, and health care systems should recommend, include, and pay for it.”

Mindfulness-based practices may be more accessible to some patients, expanding therapeutic possibilities.

“To become a mindfulness facilitator, you don’t need a clinical degree,” Dr. Hodge said. Schools or community centers could host the sessions.

Mindfulness reduces anxiety without side effects.

Dr. Hoge and her team at Georgetown University Medical Center recruited 276 people with anxiety disorders, including GAD, SAD, panic disorder, and agoraphobia.

The 276 participants ranged in age from 18 to 75, with a mean of 33. Participants were 75% female and 60% Caucasian.

Participants were first allocated to the escitalopram or MBSR group. The escitalopram group received 10–20 mg daily; the MBSR group had an 8-week practice.

In 2.5-hour lessons twice a week for eight weeks, qualified MBSR instructors taught breath awareness, body scans, and mindful movement. Participants also attended a full-day meditation retreat and meditated for 45 minutes a day for eight weeks.

“We wanted to compare Lexapro in its greatest form to meditation in its best form,” Dr. Hoge told Health.

MBSR is a unique mindfulness intervention that focuses on monitoring thoughts and emotions without judging or focusing on them; hence, the study’s results can only be applied to this practice. Other meditation approaches, like Zen meditation, aren’t appropriate.

Dr. Hoge and her team utilized the Clinical Global Impressions scale, a common questionnaire for evaluating mental health, to evaluate each intervention after eight weeks. Both groups reported 30% less anxiety after 8 weeks.

“The medicine works.” Some may be hesitant about side effects, said Dr. Hoge.

About 80% of persons in the pharmaceutical group reported at least one adverse symptom, including anxiety, difficulties sleeping, decreased libido, headaches, or nausea. Due to pharmaceutical side effects, 10 people dropped out.

15% of the mindfulness group experienced greater anxiety, the sole negative effect. This group didn’t quit.

Mindfulness therapy was time-consuming. It’s intense. Dr. Hoge recommends seeking out an MBSR-trained therapist if you think you might benefit from mindfulness-based treatment.

“I wouldn’t recommend doing it alone as a first step because so many things come up when someone starts meditating.” When questions arise, it might be helpful for those doing this challenging practice, said Dr. Hoge.

Mindfulness interrupts anxious thoughts.

The new study was the first clinical trial to directly compare medicine and mindfulness as therapies for anxiety disorders, although accumulating research suggests mindfulness and meditation can help improve a person’s relationship with worry.

Last year’s PLOS One study comprised 190 ER doctors. Researchers found that mindfulness reduces anxiety and despair.

Also last year, Current Psychology reviewed 11 studies on mindfulness and anxiety to establish how the practice reduces symptoms.

MBSR and mindfulness-based cognitive therapy (MBCT) appear to reduce anxiety and depression symptoms in patients with anxiety disorders. Mindfulness allows a person to become more aware of their mental processes and disrupt them, they theorized.

Anxiety disorders are defined by habitual worrying about the future, usually about unpleasant outcomes and a lack of control.

“People with anxiety disorders lose their sense of internal agency and ability to change,” says Stephen Ferrando, MD, of Westchester Medical Center and NYMC. “They’re looking ahead.”

Mindfulness helps manage the body’s stress reaction to future ideas and rewires how a person interacts with worry by bringing people back to the present through breath and body awareness and moving meditations.

Dr. Hoge said, “Mind and body are connected.” Anxious thoughts can elicit a physiological reaction like increased heart rate or respiration, which can cause further anxiety.

“That’s a snowball,” said Dr. Hoge. “But people can learn to ignore too many thoughts by meditating.”

Dr. Hoge says controlling these ideas doesn’t mean not experiencing them. Instead of letting fears govern one’s thoughts and body, one must recognize a worried thought, acknowledge it, and let it pass without reacting.

Dr. Hoge proposes rephrasing “I’m frightened I’ll flunk this exam” as “I’m thinking about failing this exam.”

Dr. Hoge says this builds distance between the person and the anxious idea.

Not everyone needs mindfulness-based therapy.

Mindfulness-based anxiety relief may be time-consuming and hard to maintain. Antidepressants were more likely to be continued than MBSR.

MBSR and escitalopram patients had similar initial completion rates (75% for MBSR and 76.5% for medicine), but MBSR participants dropped off faster over time. 49% of MBSR participants remained meditating at the 12-week follow-up, compared to 78% of pharmaceutical patients. At the 24-week follow-up, 52% of individuals were still taking escitalopram, whereas 28% were actively practicing mindfulness meditation.

“Not everyone is willing to commit the time and effort to finish all of the necessary sessions and perform regular home practice,” Dr. Hoge noted in a news release.

Dr. Hoge stated mindfulness-based therapy might be “provocative.”

“You’re removing distractions to reveal what’s below.” Dr. Hoge recommends cognitive behavioral therapy for those with panic attacks rather than mindfulness.

Dr. Ferrando, who was not involved in the new research, says anxiety problems commonly coexist with depression, and some people benefit more from medication than mindfulness-based therapy.

“Patients with psychosis, an unstable mood disorder, or severe PTSD can’t practice mindfulness until their symptoms get better,” he said.

Future research will examine virtual or app-based MBSR and other mindfulness-based therapies, but existing research supports mindfulness meditation as an evidence-based therapy option for people with anxiety disorders. You can read more health posts here.

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