Warding off depression: ‘mindfulness’ therapy works as well as drugs

The new finding suggests that mindfulness therapy could be used as a substitute for or addition to medication, Segal said. However, “if someone is on an antidepressant, coming off needs to be decision made with a health care professional,” he said.

The study was published in the December issue of the journal Archives of General Psychiatry.

Effects of reflection

Researchers studied 84 people ages 18 to 65 who had taken medication to treat their depression over an eight-month period, and were in remission. The researchers divided them into three groups: one continued taking medication, one underwent mindfulness-based cognitive therapy and one had their medication slowly replaced by a placebo.

“All of these patients received treatment through a hospital, so this is something that was conducted with mental health professionals keeping track of them continuously to detect possible relapse,” Segal said.

After 18 months, 38 percent of people who’d learned to meditate had relapsed, according to the study. Forty-six percent of people in the medication group relapsed, and 60 percent in the placebo group relapsed.

Because of the way the results were analyzed statistically, researchers could not conclude whether the difference between the meditation and the medication groups was due to chance, Segal said. But they could show the improvements in both of those groups over those taking the placebo was not due to chance.

The mindfulness therapy consisted of eight weeks of group training sessions, during which patients learned how to monitor their thinking patterns. They were taught to change their automatic reactions to triggers for sadness, and instead use those times as an opportunity to reflect on their feelings, Segal said. They were also taught to come up with an action plan with strategies for coping with early signs of relapse.

After the training sessions, the patients were required to set aside about 40 minutes a day for meditation and mindfulness exercises, he said.

“If you had depression triggers,” Segal said, you might turn your attention instead to the fact that “you enjoy eating your food, and that you walk outside and it’s a bright sunny day.”

Seeing results

Mindfulness-based cognitive therapy can be a good alternative to medication for multiple reasons, Segal said. Although the therapy sessions cost money, the maintenance after those sessions — daily meditation and being mindful of depression triggers — doesn’t cost a dime, he said. Maintenance medication, on the other hand, is an ongoing expense.

Pregnant women and people who don’t like the side effects or don’t want to constantly be on medication may also want an alternative to maintenance antidepressants, said Elizabeth Robinson, an assistant psychiatry professor at the University of Michigan, who was not involved in the study.

By teaching someone a new skill, they have something they can carry over with them, “whether they continue taking medication or not,” she said. Robinson teaches mindfulness-based cognitive therapy classes in Michigan and sees results in her students first-hand.

“What you see with people is they take a different look, their perspective on their personal experience shifts,” she said.

Beyond dealing with depression, meditation can help people find different ways of navigating relationships, Robinson said.

Mindfulness-based cognitive therapy is only available in large cities or places with large medical presences. Segal is researching ways to make the therapy available to people in remote communities, possibly over the Internet.

Pass it on: The study suggests that health care providers could provide information about meditation as an option to their patients who don’t want to continue taking antidepressants to prevent relapse.