Mindfulness as effective as drugs at treating anxiety

Mindfulness as effective as drugs at treating anxiety

Bruce Banner is famously bad at controlling his emotions. That’s sort of his whole deal, but in 2008’s The Incredible Hulk, he makes a real effort to put reigns on his feelings. We see him retreat from his former life and take up meditation and yoga. As a result, he hasn’t had a Hulk-shaped outburst in five months. There’s a lot about the Marvel universe which strains credulity, but this isn’t one of them.

For centuries, cultures all over the world have understood the benefit of mindfulness and meditation. Now, the scientific literature is stacking up in support of the practice. In July of this year scientists used mindfulness training to reduce physical pain in human patients and new research suggests it might be just as good at dealing with psychic pain. That’s according to a study published in the journal JAMA Psychiatrywhich used mindfulness as an alternative treatment for anxiety disorders.

Researchers recruited 430 study participants, including 276 adults with diagnosed anxiety disorders, 208 of whom completed the study. Participants were given blinded assessments at the start of the study, eight weeks later when the active part of the study ended, and then follow up assessments at 12 and 24 weeks. The idea was to gauge if, and to what degree, practicing mindfulness reduced symptoms of anxiety and how that compared to conventional drug treatments.

Participants were broken up into two groups, roughly one to one. One group received escitalopram, commonly known as Lexapro, flexibly dosed between 10 and 20 milligrams depending on the person. The second group completed a mindfulness-based stress reduction course which included two-and-a-half hour classes once per week and 45 minutes of daily practice at home. During those sessions, participants learn to pay attention to their bodies and focus on what’s happening in the moment, not what might happen in the future. When intrusive thoughts emerge, they are trained to briefly acknowledge them and then put them aside. It’s believed to help train a person to separate themselves from their emotional state and take control of their feelings.

Both groups received the entire suite of assessments, which assessed anxiety levels using the Clinical Global Impression of Severity scale. During the baseline assessment, before any intervention had taken place, the mindfulness group had a CGI-S score of 4.44 while the drug group had a score of 4.51. For reference, a score of one indicates not at all ill, while a score of seven indicates extreme illness. Both groups were hovering around four-and-a-half, between “moderately ill” and “markedly ill.” That was to be expected, the groups were randomly selected and should have had scores which were more or less the same before intervention. The question was whether mindfulness would hold up to drug treatment at reducing anxiety levels.

After eight weeks, participants received their second evaluation, and scores were bumped up against the baseline for both groups. The mindfulness group saw an average score reduction of 1.35 while the CGI-S score for the drug group dropped by an average of 1.43. That left the mindfulness and drug groups with scores of 3.09 and 3.08 respectively, on average, just above “mildly ill” on the CGI-S scale. In short, they found that mindfulness was comparably effective as frontline drug therapies at treating anxiety.

Additionally, of the patients who started treatment, 10 from the drug group dropped out due to adverse effects, while none of the mindfulness patients did. This is the first head to head comparison of mindfulness and drugs and supports the argument for mindfulness and meditation as alternative or additional therapies for anxiety disorders.

Full disclosure: some of the mindfulness patients did report increased anxiety, despite the overall decline. Like most treatments for mental illness, your mileage may vary. It’s also worth noting that not everyone has access or bandwidth to hours-long mental health interventions every week. At present, there’s no data regarding whether these results will extend to telehealth or app-based mindfulness. Of course, there’s one way to find out, at least anecdotally. Spend some time with yourself today and see if mindfulness might be right for you.

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