Can meditation top medication?
Meditation has gotten a lot of positive press lately as researchers find that it has a host of brain benefits, including helping us feel happier, and leading to the growth of brain regions responsible for building memories, regulating our emotional state, and helping us gain a sense of perspective. But can the practice help those with depression or anxiety manage their condition as well as patients on antidepressants or anti-anxiety medications?
A review of 47 clinical trials involving more than 3,500 participants with mild anxiety or depression found that those who took mindfulness meditation classes experienced improvement in mood after eight weeks — on par with the effect seen with prescription medications. The study, published Jan. 6 in JAMA Internal Medicine, found that meditation helped alleviate chronic pain in those with back trouble, arthritis, headaches, or other conditions.
“The benefits did attenuate over time — with the effectiveness of meditation decreasing by half, three to six months after the training classes ended,” said study leader Dr. Madhav Goyal, an assistant professor of medicine at Johns Hopkins University. “We don’t know why this occurred, but it could have been that they were practicing meditation less often.”
Most of the studies asked volunteers to attend weekly two-hour classes to learn mindfulness meditation — learning to focus attention on breathing, body sensations, and other experiences in the present moment. Participants were also instructed to continue their practice for 20 to 30 minutes a day at home. The meditating group was compared with a control group who attended educational classes on their particular health condition.
Meditation didn’t appear to help much in relieving everyday problems such as stress, sleep problems, or substance abuse issues. And it appeared to be about as effective as other behavioral health strategies such as exercise, group therapy, and relaxation techniques for helping people cope with mood problems and chronic pain.
“Perhaps combining meditation along with exercise or an antidepressant could be even more effective,” Goyal said. “We’d like to study that further, but right now, we can say to anyone with mild depression or anxiety that a meditation program might work for them.”
Many of the top academic hospitals in the Boston area offer meditation classes for those with a wide range of health conditions that are exacerbated by stress. Meditation guru Jon Kabat-Zinn pioneered one of the first mindfulness meditation stress reduction programs in the country at the University of Massachusetts Medical School in Worcester nearly two decades ago.
The eight-week program at UMass Medical School involves 2½-hour classes each week that include meditation, yoga stretches, and group dialogue. Students also have daily homework assignments such as meditating with an instructional audio and attend a weekend meditation retreat. The program costs $475 to $630 depending on your income, but it isn’t covered by insurance.
Massachusetts General Hospital teaches meditation and other relaxation techniques in its relaxation response resiliency program that focuses on controlling the body’s physiologic response to stress. The first three appointments with a health care provider are reimbursed by most insurance companies, but patients need to pay $450 out-of-pocket for the eight weekly two-hour group sessions.
Cancer patients at Dana-Farber Cancer Institute can take free meditation classes due to a philanthropic grant. “I see meditation almost as a requirement in any therapeutic regimen for cancer treatment, especially for patients who want a holistic approach to managing illness,” said Patricia Arcari, co-director of Dana-Farber’s Leonard P. Zakim Center for Integrative Therapies.
In weekly 90-minute group classes that meet for eight weeks, patients at any stage of cancer treatment learn mindfulness techniques at Dana-Farber as well as the physical and emotional consequences of stress. “The meditation helps with pain management, nausea, and other side effects of the treatments,” Arcari said, “but it also helps them express more self-compassion and appreciation of life.”
While Goyal and his colleagues didn’t find that meditation was associated with increased happiness or reduced stress, Arcari said she’s seen the mood-lifting benefits anecdotally over the two decades she’s been teaching meditation to patients. “I think meditation gives them more of a sense of calm, knowing that they have some tools to handle this difficult period in their lives,” she said. “In the midst of suffering, they can find some balance.”