Mindfulness meditation worked as well as a standard anti-anxiety medication in the first comparison.
The study looked at a widely used mindfulness program that includes 2 1/2 hours of lessons per week and 45 minutes of daily home practice. Participants were randomly assigned to the program or daily use of a generic drug sold under the brand name Lexapro for depression and anxiety.
After two months, anxiety as measured on a severity scale decreased by about 30% in both groups and continued to decrease over the next four months.
The results of the study, published Wednesday in the journal JAMA Psychiatry, are timely. In September, a powerful US health task force recommended routine stress screening for adults, and many reports show that global stress rates have risen recently, due to concerns about the pandemic, political and racial unrest, climate change and economic uncertainties.
Anxiety disorders include social anxiety, generalized anxiety, and panic attacks. Affected individuals are troubled by persistent and intrusive worries that interfere with their lives and relationships. In the US, anxiety disorders affect 40% of US women at some point in their lives and more than 1 in 4 men, according to data from the US Preventive Services Task Force’s screening recommendations.
Mindfulness is a form of meditation that emphasizes focusing only on what is happening in the moment and rejecting disturbing thoughts. Sessions often begin with breathing exercises. Then it can be “body scans” — systematically thinking about every part of the body, from head to toe. When troubling thoughts intrude, participants learn to acknowledge them for a while, but then dismiss them.
Instead of dwelling on the troubling thought, ‘you say, ‘I have this thought, let it go now,'” said lead author Elizabeth Hoge, director of Georgetown University’s Anxiety Disorders Research Program. With practice, “It changes relationship people have with their own thoughts when they are not meditating’.
Previous studies have shown that mindfulness works better than no treatment, or at least as well as education or more formal behavioral therapy, for reducing anxiety, depression and other mental health problems. But this is the first study to test it against a psychiatric drug, Hoge said, and the results could make insurers more likely to cover the cost, which can range from $300 to $500 for an 8-week session.
The results were based on about 200 adults who completed the six-month study at medical centers in Washington, Boston and New York. The researchers used a psychiatric scale of 1 to 7, with the top number reflecting severe anxiety. The mean score was approximately 4.5 for participants before treatment began. It fell to about 3 at two months, then fell slightly in both groups at three months and six months. Hoge said the change was clinically significant, resulting in marked improvement in symptoms.
Ten patients taking the drug dropped out of the study because of bothersome side effects possibly related to the treatment, which included insomnia, nausea, and fatigue. There were no dropouts for this reason in the mindfulness group, although 13 patients reported increased anxiety.
Dr. Scott Krakower, a psychiatrist at Zucker Hillside Hospital in New York, said mindfulness therapies often work best for patients with mild anxiety. He prescribes them with drugs to patients with more intense anxiety.
He noted that many people feel they don’t have time for mindfulness meditation, especially in-person sessions like the ones studied. It is not known whether similar results would be found with online training or phone apps, said Krakower, who was not involved in the study.
Olga Cannistraro, a freelance writer in Keene, New Hampshire, participated in a previous mindfulness study led by Hoge and says it taught her to “interfere with my own state of mind.”
During one session, simply admitting she felt tension anywhere in her body helped her calm down, she said.
Cannistraro, 52, has generalized anxiety disorder and has never taken medication for it. She was a single mom working in sales during that earlier study — circumstances that made life particularly stressful, she said. She has since married, changed jobs and feels less anxious although she still uses mindfulness techniques.
Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.
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