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Mindfulness exercises can, in some cases, be as effective as antidepressant drugs when dealing with anxiety disorders, new research reveals.
The findings highlight how mindfulness meditation could be a useful approach to treating these conditions.
The study put a course of mindfulness-based stress reduction (MBSR) techniques up against a course of escitalopram – a selective serotonin reuptake inhibitor (SSRI) class medication also known as Lexapro, considered to be a gold standard antidepressant – across eight weeks.
Follow-up surveys were carried out up to 24 weeks after enrollment using an assessment called the Clinical Global Impression of Severity scale (CGI-S), measured on a scale of 1 to 7 (with 7 being severe anxiety).
Those who had tried mindfulness saw their scores drop by an average of 1.35 points, while those on escitalopram saw their scores drop by an average of 1.43 points. In terms of statistical significance, both interventions are on the same level.
"Our study provides evidence for clinicians, insurers, and health care systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders," says psychiatrist Elizabeth Hoge from Georgetown University in Washington, DC.
Two-hundred-and-eight patients completed the course of treatment prescribed by the researchers. The mindfulness program involved two-and-a-half-hour in-person classes once a week, with a day-long retreat during the fifth or sixth week. Additionally, there were 45 minutes of daily at-home exercises.
Antidepressants can be helpful in treating anxiety, but they don't work for everyone; even SSRIs like escitalopram fall just below the standards used to evaluate adherence to medications, with significant numbers of patients failing to renew prescriptions. They can also be difficult to obtain and can come with side effects such as nausea.
"A big advantage of mindfulness meditation is that it doesn't require a clinical degree to train someone to become a mindfulness facilitator," says Hoge. "Additionally, sessions can be done outside of a medical setting, such as at a school or community center."
More than 300 million people are thought to be living with some form of anxiety disorder, making it the most common type of mental disorder at the moment. The term includes conditions like agoraphobia and can lead to an increased risk of suicide and disability.
And while mindfulness programs have previously been shown to help with anxiety, they haven't been directly compared with an antidepressant drug until now. These results are a strong indication that MBSR techniques can reduce anxiety by a similar level, as well as give individuals tools they can continue to benefit from in the future.
However, the researchers emphasize that mindfulness does require more commitment and time than taking medication. It's also not clear how effective app-based meditation exercises might be, without the in-person element.
"It is important to note that although mindfulness meditation works, not everyone is willing to invest the time and effort to successfully complete all of the necessary sessions and do regular home practice, which enhances the effect," says Hoge.
"Also, virtual delivery via videoconference is likely to be effective, so long as the live components are retained, such as question-and-answer periods and group discussion."
The research has been published in JAMA Psychiatry.
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