A new study shows that a course of mindfulness meditation can be as effective as conventional medicine in reducing anxiety.
The study, It was published in JAMA Psychiatry on November 9It included 276 adults with untreated anxiety disorders. Half of the patients were randomly selected to receive 10 to 20 mg of escitalopram, the generic form of Lexapro, a common drug used to treat anxiety and depression. The other half were assigned to an eight-week course in mindfulness-based stress reduction.
The results were impressive: both groups saw a 20% reduction in their anxiety symptoms over an eight-week period.
Elizabeth Hoge, the study’s lead author and director of the Anxiety Disorders Research Program at Georgetown University Medical Center, told CNN that she hopes the study opens up more treatment options for patients with anxiety.
“Lexapro is a great drug; I prescribe it a lot,” she said, “but it’s not for everyone.”
For patients who experience severe side effects or are allergic to antidepressants, meditation may be prescribed instead of medication, such as Hage. And starting meditation can be the first step for people with untreated anxiety and those who are wary of medication.
But the study shouldn’t be a trigger for patients to take their medications without consulting a doctor. “If someone is already on medication, they can try meditation at the same time,” says Hoge. “If they want to get off the medication, they should talk to their doctor.”
There may be unspecified reasons why some patients respond better to meditation. After data collection was complete, participants were given the option to try a treatment option they were not assigned to, Hoge said. Some patients assigned to the meditation group found that the drug was actually more effective for them, and vice versa, according to Hoge.
Hoge said further research could examine “what are the predictors of response across different treatments,” studying which patients benefit most from meditation and medication. Clinicians can then prescribe different treatment methods based on the profiles of their patients.
And she hopes the research will lead to more insurance companies covering meditation courses as an anxiety treatment.
“Oftentimes, insurance companies are willing to pay for something when there are studies that support its use,” she says. “If you know the medicine you’re paying for is just as effective, why not pay for it?”
Patients assigned to the meditation group were asked to participate in an in-person meditation group once a week. Each class is two and a half hours long and is held in a local clinic. They were also asked to meditate on their own for 40 minutes a day.
Hoge compared the time commitment to “taking an exercise class or an art class.”
But according to Joseph Arpaia, an Oregon-based psychiatrist, the focused, daily commitment to mindfulness and meditation is too much for many patients dealing with anxiety.
“Telling overworked people to spend 45 minutes a day meditating is psychotherapy’s ‘cake and eat it,'” he said in a response to Hoge’s publication, published in JAMA Psychiatry.
Arpaia said he worked to find less time-consuming mindfulness techniques to help patients manage their anxiety. One technique they teach is called the “one-breath reset,” which helps patients calm themselves in one breath.
But despite his disappointment, he says, “It’s always interesting to see meditation work, and it works with medicine.” “My hope is that people will realize that there are other things that can be done besides drugs.”
“My other hope is that sitting down and following your breath relaxes you, but it doesn’t relax everyone. Find something to do. Read a book, go for a walk, spend time gardening,” he said.
Patients assigned to the meditation group participated in a special program called mindfulness-based stress reduction, first developed by John Kabat-Zinn in the 1970s. The program is secular but based on some Buddhist teachings.
“It’s a skill you get used to,” Hoge said. “People learn to have a different relationship with their thoughts. In practice, we get people to let go of their thoughts, patiently and thoughtfully integrate them, just let them pass.”
“The practice of doing that over and over allows people to put some distance between themselves and their thoughts,” she says.
Patients shouldn’t expect meditation — or medication — to completely eliminate their anxiety, according to Hoge. “It’s normal to feel anxious,” she said. “But we can make it a little quieter.”
“People think meditation is hard, you have to take your mind off the thoughts,” she says. “That is not the case. You are still meditating even though you have thoughts. Just thinking about meditation has great value.
And Arpaia says meditation can help disrupt the feedback loops that fuel anxiety.
“Anxiety becomes something that eats itself,” he said. “Something makes a person anxious, which affects their cognitive and social skills. As the person feels more vulnerable, it increases anxiety.
Anxiety isn’t the only challenge that meditation can help patients overcome.
Research In the year It was published in the American Journal of Nursing in 2011 An eight-week mindfulness program has proven to be as effective as antidepressants in preventing relapses of depression.
Hoge said different meditation programs may be appropriate for treating depression and ADHD, among other conditions.
“I think there’s a lot of hope there,” she said.