Anxiety Treatment: Mindfulness Program ‘As Effective’ As Common Antidepressant

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A new study suggests that an 8-week mindfulness meditation program works just as well for treating anxiety as a common antidepressant. Westend61/Getty Images
  • Practicing mindfulness meditation can help relieve stress and anxious feelings.
  • Now, a new study suggests that an 8-week mindfulness program works just as well for treating anxiety as a common antidepressant.
  • The benefits of the program, known as mindfulness-based stress reduction (MBSR), are supported by research.
  • While mindfulness is not a cure-all, it can be an accessible practice to help promote a sense of calm.

It’s natural to be worried on occasion, especially when faced with stressful events. With anxiety disorders, that worry becomes persistent and can affect one or more aspects of a person’s daily life.

More than 2 in 5 women and more than 1 in 4 men in the United States will be affected by an anxiety disorder at some point in their lifetimes, according to data cited by the U.S. Preventive Services Task Force.

As such, the Task Force recently recommended that physicians screen all children and teens 8 years and older for anxiety and depression in October. Just prior to that announcement, the Task Force proposed anxiety screening for adults under 65 — but this recommendation has not yet been finalized.

Many coping strategies are available for those who live with anxiety disorders, including medication, psychotherapy, and in some cases, mindfulness meditation, which is widely touted for its health benefits.

Now, a new study suggests that an 8-week mindfulness meditation program may be just as effective as a commonly prescribed antidepressant for reducing anxiety symptoms.

The research, recently published in the journal JAMA Psychiatry, is the first randomized clinical trial (RCT) to compare the effectiveness of mindfulness-based stress reduction (MBSR) with the antidepressant escitalopram for treating anxiety disorders.

Anxiety symptoms improve with mindfulness practice

For the study, researchers recruited over 270 people with a diagnosed anxiety disorder. These diagnoses included:

  • generalized anxiety disorder (GAD)
  • social anxiety
  • panic disorder
  • agoraphobia

Participants were randomly assigned to either the MBSR program or the daily use of escitalopram (brand name Lexapro).

The MBSR program is an 8-week course that includes weekly 2.5-hour classes, one day-long weekend class, and 45-minute daily home practice exercises.

Participants learned several mindfulness techniques, including body scanning, in which attention is directed to one part of the body at a time, mindful movement, where attention is directed to the body during stretching and movement, and awareness of the breath.

After 8 weeks, both groups saw around a 30% drop in their anxiety symptoms. Symptoms decreased slightly more in both groups at 3 months and 6 months.

The most common adverse effects in the antidepressant group included insomnia, nausea, fatigue, and headache. The only adverse effect in the MBSR group was increased anxiety, which occurred in 13 people.

Around three-quarters of participants completed at least six of the nine MBSR sessions or 6 weeks of antidepressant use. However, after 6 months, only around one-quarter were still doing regular mindfulness meditation, while around half were still taking escitalopram.

One of the study’s limitations is that most participants were female with higher education levels, so the results may not apply to other groups.

In addition, researchers only compared MBSR to one type of medication for anxiety disorders.

Be that as it may, study author Dr. Elizabeth Hoge, director of the Anxiety Disorders Research Program and associate professor of psychiatry at Georgetown University in Washington, DC, told Healthline that other antidepressants have similar effectiveness as escitalopram.

This could mean that MBSR may also work as well as other antidepressant drugs.

Mindfulness is a good ‘first step’ for some

Hoge said the results of the study suggest that overall, MBSR could be a reasonable first step for certain people with anxiety, even before taking medication.

“If people are diagnosed with an anxiety disorder, and they’re very hesitant to take a medication, they could certainly start with the [MBSR] program,” Hoge said.

Mindfulness, though, may not work for everyone. Hoge added that some people in the MBSR group did not find the program to be helpful and asked to take escitalopram instead.

“It seems like there are different kinds of people who do well with different kinds of treatments,” she said. “The next step is figuring out who those are so we can try to predict which treatment might work for which people.”

Moe Gelbart, PhD, director of behavioral health at Torrance Memorial Medical Center in Torrance, CA, told Healthline that mindfulness-based practices should work for many people — provided they are willing to put in the time required to practice regularly.

But he noted that doing meditation every day is a little more difficult than taking a pill — which may deter some people from sticking with mindfulness practices.

For others, though, a do-it-yourself approach may work best.

“Mindfulness-based practices put the person in control of their own well-being, rather than them relying on someone else — such as a physician — to take care of them,” Gelbart said.

Still, Gelbert noted that people should reach out to their doctor if their anxiety symptoms are not getting better or are worsening.

“If a person has very severe anxiety and is not controlling some of their physical symptoms with just mindfulness-based exercises, then medication may be a good addition to their treatment,” he said.

People who are concerned about their anxiety symptoms, or the impact they are having on their life, should talk with their doctor about treatment options.

What is mindfulness-based stress reduction?

Mindfulness involves paying attention to the present and noticing when your mind wanders — without judgment and with an open heart.

MBSR is a structured 8-week program developed in the 1970s by Jon Kabat-Zinn, PhD, based on mindfulness meditation, body awareness, and yoga techniques.

During MBSR training, people learn a number of tools to help them focus on the present, such as bringing attention to the breath, feelings or thoughts, or body.

These techniques are used in other mindfulness, yoga, and meditation programs, as well as in mindfulness apps and mindfulness-based cognitive therapy (MBCT).

A key aspect of the MBSR program is that it is highly structured, with lots of hands-on experience. During the weekly sessions, people learn and practice these mindfulness techniques. They are also encouraged to practice on their own at home.

Research has shown that mindfulness-based interventions may reduce symptoms of depression and anxiety, improve physical health, reduce pain and stress related to chronic pain conditions and boost the immune system.

Hoge said mindfulness practices might work for anxiety disorders by helping people experience their anxious or worrisome thoughts in a different way.

“Mindfulness allows people to have some space between themselves and their thoughts, so the thought doesn’t overwhelm them,” Hoge said.

“This is different from other types of meditation, where the focus might be on relaxation. In mindfulness meditation, the focus is more on seeing things as they really are, which is not necessarily relaxing.”

Tips for practicing mindfulness

Hoge recommends that people interested in trying MBSR take a class with a qualified teacher for the best results. As with the program itself, the training to become an MBSR instructor is also highly structured.

“When people are in a class together, they’re more likely to do the practice because they’ve got a lot of support around them,” she said.

Ideally, this would be in-person, she said, but a live online class with other students would probably be just as effective.

Not everyone, though, may have access to an MBSR program, in person or online. But there are a few basic mindfulness tips that can help calm anxious feelings that can be practiced independently at home.

  • Set aside time. Practicing mindfulness regularly will help you experience the benefits of mindfulness sooner. Start with 5 to 10 minutes a day.
  • Avoid distractions. Choose a quiet place that is free from distractions. Be sure to silence your phone.
  • Observe the present moment. The goal of mindfulness is to bring your attention to what is happening right now without judgment.
  • Choose an object to focus on. This can be as simple as the breath, the sensations in the body, or your thoughts.
  • Try mindful action. Some people have better luck practicing mindfulness while walking, washing the dishes, or doing another simple action. With these, bring your attention to the action, such as noticing the feel of the earth under your feet as you walk.
  • Keep coming back. If your mind wanders — and it inevitably will — gently bring your attention back to the present moment.
  • Be kind to yourself. Don’t worry if you find it difficult to stay present. Mindfulness, like other skills, grows stronger the more you practice.

Takeaway

A new study builds on a growing body of evidence supporting mindfulness meditation for anxiety relief.

The research suggests that mindfulness-based stress reduction (MBSR) may be as effective for treating anxiety as a commonly prescribed antidepressant.

Still, mindfulness is not a magic bullet and may not work for everyone.

Some individuals living with anxiety disorders may experience greater relief from their symptoms with medication, psychotherapy, or a combination of both.

If you’re interested in learning more about the benefits of mindfulness meditation, ask your doctor or mental health professional if it’s the right option for you.

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