Meditation is as effective as anti-anxiety medication, study finds

The first study to directly compare medication with meditation for anxiety finds that the two methods work equally well in reducing symptoms.

The finding, published Wednesday in the journal JAMA Psychiatry, suggests that people struggling with anxiety could be helped by either a daily pill (which could come with side effects) or a daily mindfulness practice (which requires substantial time commitment).

“For both treatments, we had people say, ‘This really worked,'” said study author Dr. Elizabeth Hogg, director of the Anxiety Disorders Research Program and associate professor of psychiatry at Georgetown University Medical Center in Washington.

About 6.8 million adults in the U.S. have generalized anxiety disorder, but fewer than half receive treatment, according to the Anxiety & Depression Association of America.

The two-month study included 276 patients diagnosed with generalized anxiety disorder. Half were given a common antidepressant—escitalopram (brand name: Lexapro)—and the other half participated in a mindfulness-based stress-reduction program.

Both groups reported modest improvements: a 20% reduction in symptoms at the end of the study, regardless of their treatment.

That kind of benefit is consistent with other studies of drugs to treat anxiety, said Craig Sawchuk, a psychologist at the Mayo Clinic in Rochester, Minnesota, who was not involved in the new research.

The study “shows that there are non-medical alternatives to treating anxiety that are just as effective,” said Lindsey McKernan, associate professor of psychiatry and behavioral sciences at Vanderbilt University Medical Center in Nashville, Tennessee. are also not participating in the study.

Side effects were more common among those who received the antidepressant. nearly 80% of participants experienced at least one side effect, including sleep problems, nausea, headaches, decreased libido, and increased anxiety. Most were considered mild.

Only one side effect, increased anxiety, was reported in the mindfulness group, by about 15% of participants.

The mindfulness program, however, was time-consuming: Participants had to attend 2 1/2-hour group classes twice a week for eight weeks, plus a full day at a meditation retreat. In addition, they were told to practice meditation for 45 minutes every day for the entire study period.

Hoge noted that at a six-month follow-up, 58% of people in the Lexapro group were still taking the drug, while just 28% in the meditation group were still practicing mindfulness at least four days a week.

It’s unclear why so many meditation participants seemed to drop out, he said. It could be that they were no longer experiencing symptoms, or that the time constraints were simply too long.

“It may be easier to remember to take a medication once a day,” than to fit in a 45-minute meditation, Sawchuk said.

However, the time commitment to mindfulness throughout the study was important for people to learn the proper techniques, Hoge said. Mindfulness involves focusing on a single thing, usually the breath, or the sounds happening around you, and clearing the mind of other thoughts.

This is hard to do for more than a few seconds before the mind wanders and returns to thinking about other things: to-do lists, what ifs, worries about the future. Mindfulness teaches the brain not to be so overwhelmed by these disturbing thoughts.

The thinking behind mindfulness, Hoge said, is that it can make anxiety-fueling thoughts less powerful. He gave an example of a person who was worried about failing an exam. “Before treatment, this thought makes them sweat and nervous and they can’t think about anything else,” she said. “But the problem is only the thought itself, not the reality.”

Learning to accept such thoughts and move on “creates freedom,” Hoge said. “The thought arises and need not take control of the person.”

“It’s like I’m helping you build a system where you can learn how to respond to stress instead of reacting to it,” McKernan said.

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