If there’s one thing that can be said of buzzwords, it’s that they almost always fall by the wayside in the end. Yet in the field of mental health, one buzzword has survived the best efforts of critics and naysayers – “mindfulness”.
First coined by Dr Jon Kabat-Zinn from the University of Massachusetts Medical School, the term mindfulness was initially characterised as a state of mind that would enable someone to pay “attention on purpose” to the present moment. Modern secular society seems to have embraced it as a form of meditation. Everything from exercise to breathing now has an associated mindfulness manual attached.
However, not everyone is convinced. For example, the recent phenomenon of adult colouring books – devised to promote mindfulness and serve as a form of therapeutic escapism – has been criticised by therapists as over-hyped and not necessarily helpful.
Meanwhile, sceptics have pointed out an alleged bias in the publishing of positive findings from trials using mindfulness as a form of mental health therapy. Researchers at McGill University in Canada “found that scientists reported positive findings 60 per cent more often than is statistically likely” after analysing 124 different published trials involving mindfulness as a form of mental health therapy. In some cases, the practice has even had a reverse effect, inducing anxiety, pain or panic.
However, a new study published in the journal JAMA Psychiatry seems to demonstrate that mindfulness-based cognitive therapy (MBCT) can be a potent treatment in preventing and managing relapse into major depression. Led by the University of Oxford, the study’s researchers conducted the largest meta-analysis (an analysis of various different studies) to date on the therapy’s impact on recurrent depression.
The particular form of mindfulness-based cognitive therapy that was used aimed to equip patients with the skills required to successfully recognise and repel the thoughts and feelings they most commonly associated with the state of depression, in order to prevent any future relapse.
According to the study, “the MBCT course consists of guided mindfulness practices, group discussion and other cognitive behavioural exercises. Participants receiving MBCT typically attended eight 2-2.5 hour group sessions alongside daily home practice.”
Using anonymous patient data from nine randomised trials involving 1,258 participants, researchers found that 38 per cent of those who received mindfulness-based therapy experienced a depressive relapse, in comparison to 49 per cent of patients who didn’t receive treatment. The patient data covered age, sex and level of education – key inclusions, as the meta-analysis was able to show no significant influence by these factors on the therapy’s performance.
The most prominent form of remedy currently available for mental health patients is anti-depressant medication. Four of the nine randomised trials comparatively assessed the impact of therapy alongside medication, to deduce if a combination of therapy with varying doses of medication was more beneficial than medication alone. The patients from the study who received mindfulness therapy along with continued, reduced or discontinued medication were less likely to fall back into depression than patients on maintenance anti-depressants alone. This helps legitimise mindfulness as an option in combating depression’s debilitating effects and reinforces its efficacy, whether it is taken up with or without anti-depressants.
Willem Kuyken, Professor of Clinical Psychology at the Oxford Mindfulness Centre and lead author of the study, called the results “very heartening”. “While MBCT is not a panacea, it does clearly offer those with a substantial history of depression a new approach to learning skills to stay well in the long-term.
“It offers people a safe and empowering treatment choice alongside other mainstay approaches such as cognitive-behavioural therapy and maintenance antidepressants. We need to do more research, however, to get recovery rates closer to 100 per cent and to help prevent the first onset of depression, earlier in life. These are programmes of work we are pursuing at the University of Oxford and with our collaborators around the world.”
Though the findings will certainly reinvigorate confidence in mindfulness, Richard Byng from the University of Plymouth and one of the co-authors said, “clinicians need to be cautiously optimistic when tapering off antidepressant medication, and treat each patient as an individual who may or may not benefit from both MBCT and other effective treatments.”