Study: Mindfulness Meditation Works as Well as Common Antidepressant to Reduce Anxiety

Mindfulness meditation has emerged as a promising treatment option for anxiety disorders, with research showing its effectiveness comparable to commonly-used antidepressants. A randomized clinical trial published in JAMA Psychiatry demonstrated the efficacy of mindfulness-based stress reduction (MBSR) in treating anxiety when compared to the antidepressant escitalopram. This study contributes to a growing body of evidence supporting the use of mindfulness as a powerful tool for managing anxiety.

The findings suggest that clinicians, insurers, and healthcare systems should consider recommending and providing reimbursement for mindfulness-based stress reduction as a treatment for anxiety disorders. Currently, mindfulness meditation is only reimbursed by a limited number of providers. By recognizing its effectiveness, more individuals can access this treatment option, potentially expanding treatment choices and making it more accessible to patients.

One of the advantages of mindfulness meditation is its versatility and accessibility. Unlike some treatments that require specialized training, mindfulness can be taught by non-clinicians, making it a more widely available option. Sessions can be conducted outside of traditional medical settings, such as schools or community centers, providing flexibility in delivering this intervention.

The study’s results highlight the potential of mindfulness meditation to be integrated into mental healthcare practices and contribute to the overall well-being of individuals struggling with anxiety disorders. It emphasizes the importance of considering mindfulness as a valid and evidence-based treatment option for anxiety, ultimately improving patient care and expanding treatment choices.

Mindfulness Shown to Reduce Anxiety Symptoms With Fewer Side Effects

In the study conducted by Dr. Hoge and her team at Georgetown University Medical Center, 276 individuals diagnosed with generalized anxiety disorder, social anxiety disorder, panic disorder, or agoraphobia were recruited. Out of the initial participants, 208 completed the trial, with ages ranging from 18 to 75 and a mean age of 33. The majority of participants were female (75%) and white (60%).

Participants were assigned to either the escitalopram group or the mindfulness-based stress reduction (MBSR) group. The escitalopram group received a daily dose of 10-20 mg of the medication, while the MBSR group underwent an 8-week MBSR program. The MBSR program involved attending 2.5-hour group classes twice a week, led by qualified MBSR instructors who taught various forms of mindfulness meditation such as breath awareness, body scans, and mindful movement. Participants also attended a full-day meditation retreat and were asked to practice meditation for 45 minutes daily throughout the entire eight weeks.

At the end of the study, the researchers used the Clinical Global Impressions scale to assess the effectiveness of each intervention. Both groups reported an average 30% reduction in anxiety symptoms after the eight-week period.

While the medication group experienced more side effects, including increased anxiety, trouble sleeping, decreased libido, headaches, and nausea, the majority of these side effects were mild. About 80% of individuals in the medication group reported at least one side effect, and ten participants dropped out due to side effects. In contrast, the mindfulness group had only one reported side effect of increased anxiety, and no participants dropped out.

It is important to note that the MBSR program used in this study focused specifically on mindfulness meditation and cannot be generalized to other meditation practices. The results highlight the effectiveness of MBSR as a specific mindfulness intervention for anxiety treatment.

Dr. Hoge emphasized that while mindfulness therapy can be beneficial, it requires time and effort, and seeking guidance from a trained professional in MBSR is recommended rather than attempting it alone. The support of a trained professional can help navigate any challenges that arise during the practice.

Mindfulness Can Interrupt Anxious Thought Patterns

Mounting research over the past decade has indicated the potential of mindfulness and meditation in improving one’s relationship with anxiety. For example, a study involving medical professionals working in emergency rooms found that those who practiced mindfulness were less likely to experience anxiety and depression. Another review on mindfulness and anxiety revealed that mindfulness-based practices such as MBSR and MBCT have shown efficacy in reducing symptoms of anxiety and depression in individuals with anxiety disorders. These practices help individuals become more aware of their thought processes, allowing them to interrupt and modify them.

Anxiety disorders are characterized by persistent worrying thoughts about the future, often centered around negative outcomes and a perceived lack of control. Mindfulness practice, through breath and body awareness and moving meditations, brings individuals back to the present moment and helps regulate the body’s stress response to future thoughts. It allows individuals to rewire their relationship with anxiety by shifting their focus from external worries to the present experience.

Mindfulness practice helps individuals recognize that anxious thoughts trigger physiological responses, which can further exacerbate anxiety. By practicing mindfulness, individuals learn not to let these thoughts overwhelm them and develop the ability to set them aside. This interrupts the snowball effect of anxious thoughts and physiological responses. Rather than eliminating anxious thoughts altogether, mindfulness teaches individuals to acknowledge the thoughts without reacting to them, creating distance between the person and the anxiety-provoking thoughts.

By reframing anxious thoughts and recognizing them as passing thoughts rather than facts or threats, individuals can interrupt the feedback loop of anxiety. For instance, shifting the thought “I’m scared I’m going to fail this exam” to “I’m having a thought about failing this exam” allows individuals to create a sense of distance and reduce the impact of anxiety.

Mindfulness-Based Therapy May Not Be Right for Everyone

While mindfulness-based approaches have shown efficacy in reducing anxiety symptoms, they may be more challenging for some individuals to stick with compared to medication. The study found that participants in the mindfulness group were more likely to discontinue their practice over time compared to those on medication. By the 24-week follow-up, only 28% of participants were still regularly practicing mindfulness meditation, while 52% were still taking medication.

Engaging in mindfulness-based therapy requires a significant investment of time and effort, including attending sessions and engaging in regular home practice. Not everyone may be willing or able to commit to this level of involvement, which can impact the effectiveness of the approach. It’s important to acknowledge that mindfulness meditation is not always a relaxing practice and can be somewhat provocative as it allows underlying thoughts and emotions to emerge.

For individuals with specific anxiety symptoms like panic attacks, cognitive-behavioral therapy (CBT) may be a more targeted approach. CBT directly addresses anxiety symptoms and is recommended for such cases instead of mindfulness-based interventions. Additionally, some individuals with co-occurring conditions like depression may benefit more from medication than mindfulness-based interventions.

Furthermore, not all patients, especially those with severe symptoms or certain conditions such as psychosis or unstable mood disorders, may be able to participate in mindfulness practice until their symptoms are reduced or stabilized.

While future research may explore virtual or app-based mindfulness interventions, the current study supports mindfulness meditation as an evidence-based treatment option for adults with anxiety disorders. It is important to consider individual preferences, needs, and circumstances when choosing the most appropriate treatment approach, whether it be mindfulness-based therapy, medication, or other interventions. Consulting with a healthcare professional can help determine the best course of action.