Listening to Mindfulness (The Depression & Anxiety Edition)

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We've heard a lot about the efficacy of mindfulness for the treatment of anxiety and depression. In fact, dozens of studies have been published claiming to establish mindfulness as an effective treatment for mood disorders. 

But what if we apply the gold standard we've been using to separate the wheat from the chaff? Just what kinds of impacts does mindfulness deliver when we drop the correlational designs, the waitlist controls, the self-report measures?

What do the best studies actually show?

(This is the fifth installation in a six part series on the known benefits of mindfulness and meditation. For the intro, click here.)

Well, a well-designed 2014 meta-analysis did just that. 

Writing in JAMA Internal Medicine, Madhav Goyal and his colleagues at Johns Hopkins sorted through 18,753 studies about the effects of mindfulness and meditation and ditched everything that didn't meet their exacting standards. They were left with 47 gold standard studies - just the studies that included an active control for placebo effects.

What did they find? 

They found that "meditation programs" are "only" as effective as Selective Serotonin Reuptake Inhibitors (SSRIs).

In other words, they discovered that mindfulness is "only" as effective as the most effective treatment for depression the world has ever known. Remember Listening to Prozac, Larry Kramer's 1993 ode to SSRIs, which promised we could all be "better than well?"

And lest we attribute these findings to Dr. Goyal's deep love for meditation, a more recent randomized clinical trial by Willem Kuyken and his colleagues at Oxford found that Mindfulness-Based Cognitive Therapy (MBCT) was just as effective as SSRI's in preventing relapses of depression, even among severely depressed patients. 

(For a fuller treatment of this study, click here and here.)

And as Richie and Dan (Ch. 10) note, the evidence just keeps getting stronger. For instance, one recent study found that anxiety sufferers who underwent an eight-week Mindfulness-Based Stress Reduction (MBSR) program saw significant reductions in amygdala activity when triggered with panic-inducing phrases like, "people always judge me."

Conclusion: meditation makes you less freaked out by what freaks you out.

British novelist Julie Meyerson sums it up nicely. Writing in the Guardian about her experience with MBCT after a lifetime of suffering from clinical depression, she says:

"Somehow, somewhere, across those six weeks, something happened inside me – in my head? my body? my soul? – and I began to understand. Sitting still became a boon and a comfort, even a luxury, rather than a threat or an irritation. And the present moment, right here, right now, began to seem a very comfortable (and comforting) place to be, bereft of dread and full of the possibility of peace and calm."

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Devon and I will be teaching in Kauai, Ashland, Iceland, the Faroe Islands, Denmark, and other destinations in the next few months. For more info, please click here.

Craig Hase