Mindfulness may be ‘as effective’ as anti-depressants for preventing relapse in recurrent depression

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May 1, 2015
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A New Option in the Treatment for Depression

Mindfulness-based cognitive therapy (MCBT) may be as good as pills at preventing people who are recovering from major bouts of depression from relapsing, according to a new study led by Oxford University.

The trial, published in the Lancet medical journal, involved 424 adults from GP practices in the south west of England, who were willing to try either antidepressant drugs or the therapy.  The two-year study looked at 424 patients from 95 general practices and split the group in half, with 212 on anti-depressants and 212 undergoing MBCT while gradually reducing their medication.

The researchers concluded that the treatment could offer patients a new option in their treatment for depression, aside from courses of medication favoured in National Institute for Health and Care Excellence (NICE) guidelines.


They said:

“We found no evidence that MBCT is superior to maintenance anti-depressant treatment for the prevention of depressive relapse in individuals at risk for depressive relapse or recurrence.

“Both treatments were associated with enduring positive outcomes in terms of relapse or recurrence, residual depressive symptoms, and quality of life.

“The implication is that for patients at low risk, treatments such as psycho-education or maintenance anti-depressants, which require less patient commitment and cost, might be indicated, whereas for patients at highest risk, more intensive treatments such as MBCT could be indicated.

“This implication has substantial potential to improve prevention by maximising the delivery of treatments through stratified approaches, which also have the potential to improve patient choice.”


A New Choice for the Millions of People with Recurrent Depression

Richard Byng, a professor at Britain’s Plymouth University Peninsula Schools of Medicine and Dentistry, said that, while current standard treatment for chronic depression is to keep taking anti-depressants, many people don’t want to take them for long periods and others want to avoid side-effects.

“Whilst this study doesn’t show that mindfulness-based cognitive therapy works any better than maintenance anti-depressant medication in reducing the rate of relapse … these results suggest a new choice for the millions of people with recurrent depression on repeat prescriptions,” said Willem Kuyken of Oxford University, who worked with Byng on the research.


Mindfulness-Based Cognitive Therapy (MBCT)

MBCT was developed to help such people by teaching patients skills to recognise and respond constructively to thoughts and feelings associated with relapse, aiming to prevent a downward spiral into depression.

MBCT combines the problem-solving approach of cognitive behavioural therapy (CBT) with mindfulness techniques. These are designed to focus your awareness on the “here and now” instead of having unhelpful thoughts about the past and the future.  Psychcentral explains mindfulness training as a way of paying full attention to the present moment that can “mitigate the cognitive symptoms of depression.”

The practice can be very beneficial as it trains individuals to slow down enough to become more aware of their thoughts without passing judgment on them but acknowledging them as inaccurate reflections on what is really going on. This process empowers the individual as the practice helps them to become less and less carried away by distorted visions of themselves and the world.


Clinical Depression

Clinical depression is a global health issue and it affects millions of American adults. Each year, roughly 6.7 percent of the U.S. population, 18 years and up, suffers.  Forbes reports that 50 to 80 percent of people who experience depression are at risk for a relapse.

Undiagnosed depression costs millions of euros annually in lost work days and decreased productivity as those affected may not be able to think clearly or perform well. Statistics show that these numbers have been growing with repercussions that can lead to other health concerns such as heart disease and stroke. Awareness is key in changing these disheartening facts. It means educating the public about measures to take in order to prevent and treat depression.

A recent study also states that awareness, as in mindfulness-based cognitive therapies can also be key as a practice proven to be just as effective as taking antidepressants.


Changing Patterns of Thought and Behaviour

According to Forbes Magazine, there has been an increasing number of evidence that this type of therapy has positive effects on the brain.

Mindfulness-based cognitive therapy marries mindfulness training or meditation with cognitive behaviour therapy. These two practices are similar, even when not combined. Together, they take a goal-oriented approach that teaches those who use it to change the patterns of their thought and behaviour which also changes the way they feel and react to their everyday lives.

Negative and destructive thoughts are replaced with more positive and productive thoughts, causing subjects to become less imposed upon by the thoughts that were once crippling.

Research suggests that mindfulness can benefit several populations, not just people with a history of severe depression, however, caution must be exercised as mindfulness-based approaches are unsuitable for some client groups.


Exclusion criteria and recommendations are available from:

Mindfulness-Based Stress Reduction (MBSR): Standards of Practice, edited by Saki F. Santorelli, Centre for Mindfulness University of Massachusetts, Director of Stress Reduction Program, February, 2014.

‘Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial’ by name of Kuyken et al. published in The Lancet on Tuesday 21st April.

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