Mindfulness Meditation & Cognitive Therapy for Depression

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Mindfulness in a Frantic World by Mark Williams, Ph.D., and Danny Penman, Ph.D. describes the effectiveness of a combination of cognitive therapy and mindfulness meditation to create MBCT (mindfulness-based cognitive therapy MBCT).  MBCT is a combination of Eastern meditation with Western cognitive therapy. Patients are taught the simple technique over eight sessions and then practice it at home for 30 minutes a day.  Their argument is that MBCT is equal to or more effective than use of antidepressants to manage symptoms of depression.

MBCT was developed in the 1990's by psychologists at the Universities of Oxford, Cambridge, and Toronto.  MBCT was created to help stabilize patients' moods during and after the use of antidepressants, and these psychologists found that approximately half of patients relapse into depression when sadness turns into obsessive brooding.  The authors report: “Brooding is a key feature of depression," says Mark Williams, professor of clinical psychology at the University of Oxford and leader of the team that developed MBCT. "In mentally healthy people, sad thoughts pass quite quickly but in people who suffer from depression they don't. MBCT tackles brooding and teaches people to be more compassionate to themselves and others."

Depression has many factors that contribute to the ongoing symptoms of and relapse into depression. “One of the key features of depression is that it hijacks your attention," says Professor Williams. "We all tend to bring to the forefront of our minds the thoughts and feelings that reflect our current mood. If you are sad, depressed or anxious, then you tend to remember the bad things that have happened to you and not the good. This drives you into a downward spiral that leads from sadness into a deeper depression. MBCT prevents and breaks that spiral."

The article's authors indicate that "Psychologists from the University of Exeter recently published a study into "mindfulness-based cognitive therapy" (MBCT), finding it to be better than drugs or counseling for depression. Four months after starting, three quarters of the patients felt well enough to stop taking antidepressants.”

To further support their argument, they indicate that "Professor Willem Kuyken, whose team at the Mood Disorders Centre of the University of Exeter in the UK carried out the research, says: "Anti-depressants are widely used by people who suffer from depression and that's because they tend to work. While they're very effective in helping reduce the symptoms of depression, when people come off them they are particularly vulnerable to relapse. For many people, MBCT seems to prevent that relapse. It could be an alternative to long-term antidepressant medication."

Meditation Technique

1. Sit upright in a straight-backed chair, with your spine about an inch from the back of the chair, and your feet flat on the floor.

2. Close your eyes. Use your mind to watch your breath as it flows in and out. Observe your sensations without judgment. Do not try to alter your breathing.

3. After a while your mind will wander. Gently bring your attention back to your breath. The act of realizing that your mind has wandered - and bringing your attention back - is the key thing.

4. Your mind will eventually become calm.

5. Repeat every day for 20-30 minutes.

With an increase in mental health issues such as depression and anxiety, alternative approaches to managing symptoms are needed.  Mindfulness meditation can be used concurrently with medication or as an alternative to medication.  Many people who use medication could benefit from also using mindfulness meditation to better manage symptoms.  In addition, many people are fearful of medication and their symptoms remain untreated.  This alternative approach could prove to be very beneficial.  It will be interesting to see if there is a study that can identify if a specific number of training sessions has a greater significant outcome on managing depression and anxiety symptoms.  I believe that if clinicians, psychiatrists and doctors are trained in mindfulness meditations, it is a resource they can give to their patients or clients.  While clients need to be trained in how to use mindfulness meditation, practioners also need to be trained, as this is not a common class that is taken in the educational curriculum at most universities.  If practioners could be trained, they could offer more assistance to their patients or clients.  I hope that this could be an additional approach by those serving people who are trying to manage depression and anxiety.  

- Kim B.

Insightful Comments

On the occasions that I have served as a counselor over the years, many of the people that I listened to and served came to me with their own diagnosis. I would guess that all of us self diagnose our own ailments, be they physical, mental, or emotional, but the challenge with self-diagnosis is that it may often be accurate with ourselves, and we may not know how to treat our own conditions.

For example, after having dozens or even hundreds of sinus infections over the years, I have a better than average rate of self-diagnosis for the illness. However, since I am not a medical doctor and over the counter medications don’t always work, I must make a trip to my physician’s office to get a prescription - I disdain going to see someone, tell them what is wrong, and then paying them when I felt like I did the work.  When the people I have counseled came to me believing that something was wrong, they were correct in their thinking. Often, their diagnosis was correct, even if they didn’t know the fancy medical terms, but they didn’t know how to treat the problem. 

Different treatment methods cannot only co-exist, they can also truly compliment one another, so I certainly support the exploration of new and innovative methods such as CBT and Mindfulness in order to treat depression whether this results from a self-diagnosis or otherwise.  Perhaps mindfulness and cognitive therapy could be applied to one's life even without the intervention of a physician - We will have to see whether this becomes a new treatment restricted to the medical community, or if this becomes a daily practice that is adopted by the general public (i.e. an over-the-counter practice).


- Bergen



References

Williams, Ph.D., and Danny Penman, Ph.D. Walton, Alice (October 14, 2011) Mindfulness in a Frantic World

Retrieved from http://www.psychologytoday.com/blog/mindfulness-in-frantic-world/201110/curing-depression-mindfulness-meditation