Even ordinary depression and anxiety disorders seem to yield to MBCT treatment — though it is no better in this regard than medication. (These findings are significant, however, when you consider that many people have avery hard time getting off of antidepressants.) “If mindfulness-based interventions work about comparably to CBT or antidepressants, that’s not necessarily a bad thing,” said Van Dam. “It may be that people like the mindfulness stuff better. If that’s the case, what you need to show is that people will commit and follow through with the intervention better than the other therapies.” MBCT is now endorsed by the American Psychiatric Association for preventing relapse in patients who have suffered three or more episodes of depression, but not for regular depression and anxiety. The U.K. National Institute of Health and Clinical Excellence also recommends it over more conventional treatments for preventing depressive relapse.
The picture is more mixed when it comes to the mental health benefits of straight mindfulness-based stress reduction courses, without the cognitive behavioral component. One widely-cited meta analysis published in Jama Internal Medicine in 2014 by Johns Hopkins Medicine’s Madhav Goyal and colleagues reviewed 47 trials with 3,515 participants and found moderate evidence that eight weeks of mindfulness-based stress reduction practice could improve anxiety, depression and pain, but that it did no better than exercise, drugs, or other behavior therapies. They also found low evidence of improved stress/distress and mental health quality of life and low or insufficient evidence of improved mood, attention, substance use, eating habits, sleep, or weight.
Further complicating the story, some researchers have identified potential adverse effects of mindfulness meditation, though the study of these effects is only in its infancy and the incidence is so far low. Over 20 individual case reports and observational studies have identified various forms of clinical deterioration associated with mindfulness meditation, including meditation-induced “depersonalization” as well as retriggering of trauma, mania, panic and psychosis. As a result, numerous authors have recommended that individuals with any indications of suicidality, schizophrenia spectrum disorders, bipolar disorder, post-traumatic stress disorder, depression, and risk factors for psychosis, should not participate in a meditation-based intervention that is not specifically tailored to one of these conditions.
An ambitious seven-year study is currently underway to look at the impact of meditation on the mental health of 7,000 teenagers aged 11 to 16 from 76 secondary schools, given that many mental disorders begin to emerge at these ages. The research study is led by Oxford’s Willem Kuyken in partnership with other psychologists and neuroscientists from Oxford University and University College London (UCL) and is funded by The Wellcome Trust. Starting in 2016, around 3,000 British youth received training in mindfulness techniques via a 10-week course involving a weekly 30-minute lesson plus up to 20 minutes’ daily home practice. A second group of around 3,000 individuals received standard personal, health and social training lessons. Over the following two years both groups are being monitored for depression and other mental disorders.
Another 600 students will be tested by Professor Sarah-Jayne Blakemore at UCL before and after mindfulness training to assess self-control and emotional regulation. Blakemore wants to find out exactly at what point during adolescence, a period of great reorganization of the prefrontal cortex, mindfulness has the most effect, she recently told The Guardian.
At the other end of the age spectrum, a five-year $15 million National Institutes of Health study launched in 2015 is examining strategies, including meditation, that can help older adults prevent or reverse age-related cognitive decline. The study team, led by Eric J. Lenze, includes a cross-disciplinary group of 14 researchers at the Washington University School of Medicine in St. Louis from fields such as psychiatry, medicine, radiology, neurology, biostatistics, physical therapy, and occupational therapy. The researchers recruited 580 people over age 65 who have significant problems with thinking and memory, but have not been diagnosed with clinical dementia common to conditions like Alzheimer’s disease. Another $3 million, five-year National Institutes of Health study launched in 2015 is looking at stress management strategies, including mindfulness meditation, for reducing loneliness in older adults.
Another large-scale interdisciplinary study funded by the National Institutes of Health and conducted by 12 basic science and clinical mindfulness researchers at four U.S. universities — Harvard, Brown, University of Massachusetts, and Georgetown — will attempt to examine how mindfulness influences self regulation, which is critical to a number of health problems influenced by behaviors like excessive eating, lack of physical activity, addiction and poor adherence to medical regimens. The project, to be conducted in four stages, will attempt to identify behaviors associated with self regulation that can be manipulated through therapies, identify the therapies that can influence them, and ultimately pilot test these in two separate mindfulness-based intervention trials for managing chronic medical conditions: the Mindfulness-based hypertension study and the mindful primary care study.