MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Mindfulness is one of the 150 so-called alternative medicines (SCAMs) that I have evaluated in my recent book ‘Alternative Medicine: A Critical Assessment of 150 Modalities‘. Here is an excerpt from my text:

Mindfulness is a form of meditation which involves bringing one’s attention to experiences occurring in the present moment while sitting silently and paying attention to thoughts, sounds, the sensations of breathing or parts of the body.

    1. Many experts do not consider mindfulness to be an alternative therapy but see it as a set of psychological methods that have long become well-accepted, conventional treatments.
    2. There are several forms of mindfulness meditation; one of the best-known and most thoroughly researched is Mindfulness-Based Stress Reduction developed by Jon Kabat-Zinn (1944- ). It uses a combination of mindfulness meditation, body awareness, and yoga to help people become more mindful.
    3. Mindfulness programs are currently popular and have been widely adopted in schools, hospitals, and other settings. They are also being applied to initiatives such as for healthy aging, weight management, athletic performance enhancement, for children with special needs, and as a help during the perinatal period.
    4. Novices are advised to start with short periods of about 10 minutes of meditation practice per day. With regular practice, it becomes easier to keep the attention focused and the length of time spent practising can be extended.
    5. There has been much research interest in mindfulness, and many studies are now available. However, the quality of these trials is often poor which is one reason why the evidence is less clear than one would hope.
    6. Several systematic reviews have assessed mindfulness for various medical conditions, e. g.:Image result for mindfulness meditation
    • A systematic review of mindfulness for chronic headaches concluded that, due to the low number, small scale and often high or unclear risk of bias of included randomized controlled trials, the results are imprecise; this may be consistent with either an important or negligible effect. Therefore, more rigorous trials with larger sample sizes are needed.[1]
    • A systematic review of mindfulness for addictions found support for the effectiveness of the mindfulness-based interventions.[2]
    • An overview included 26 reviews and found a substantially consistent picture… Improvements in depressive disorders, particularly recurrent major depression, were strongly supported. Evidence for other psychological conditions was limited by lack of data. In populations with physical conditions, the evidence for significant improvements in psychological well-being was clear, regardless of population or specific mindfulness intervention. Changes in physical health measures were inconclusive; however, pain acceptance and coping were improved.[3]
    1. Some reports have linked mindfulness to increasing fear and anxiety panic or “meltdowns” after treatments. However, these seem to be rare events; in general, mindfulness is considered to be a safe therapy.

[1] https://www.ncbi.nlm.nih.gov/pubmed/29863407

[2] https://www.ncbi.nlm.nih.gov/pubmed/29651257

[3] https://www.ncbi.nlm.nih.gov/pubmed/29306938

Now there is new evidence regarding the safety of Mindfulness, including an estimate of the incidence of adverse effects. An article in the NEW SCIENTIST warned that about one in 12 people who try meditation experience an unwanted negative effect, usually a worsening in depression or anxiety, or even the onset of these conditions for the first time, according to the first systematic review of the evidence. “For most people it works fine but it has undoubtedly been overhyped and it’s not universally benevolent,” says Miguel Farias at Coventry University in the UK, one of the researchers behind a paper which as yet is not available on-line.

Farias’s team combed through medical journals and found 55 relevant studies. Once the researchers had excluded those that had deliberately set out to find negative effects, they worked out the prevalence of people who experienced harms within each study and then calculated the average, adjusted for the study size, a common method in this kind of analysis. They found that about 8 per cent people who try meditation experience an unwanted effect. “People have experienced anything from an increase in anxiety up to panic attacks,” says Farias. They also found instances of psychosis or thoughts of suicide.

I will add a link to the original paper, once it has been published

 

32 Responses to Mindfulness can worsen depression and anxiety

  • When I was young, Penguin published a series of Ladybird guides were thin hardback illustrated books covering a wide range of subjects (trains, wildlife…) aimed at educating and informing children. I haven’t seen them for a long time, but there are now equally informative Ladybird guides in the same format and aimed at the same readers (i.e. the adults who grew up with the original Ladybird guides all those years ago) but covering such subjects as Dating, The Wife, Hangovers, Trump… and Mindfulness.

  • Oh…and so it is OK now to reference studies that are not randomized, double-blind, or placebo controlled…well, as long as they give YOU the outcome that YOU want. “How convenient!”

    I look forward to your creative responses that will inevitably include an ad hom or two.

    And then, one could also ask: what is the “mechanism” by which this negative result occurs, and like with certain subjects, clinical results don’t get published until the authors of a clinical trial provide “evidence” of the precise mechanism of action.

    Well, because the results of this study fits your paradigm, it is fun and funny to watch you avoid these subjects. Once again, “how convenient!”

  • Talking about “mindfulness meditation” in general is a helpful as talking about “dieting” in general. Its always a matter of the details of the technique and the strength of the daily practice.

    My personal experience is that I had severe depression for 14 years. I made a lot of progress with improved diet but the core of it was still strong. I did five 10-day Vipassana retreats in a tradition that comes from Burmese Buddhism (dhamma.org). In each retreat the depression surfaced strongly and I observed it using the method taught. In the 5th retreat I remember the exact moment when it dissolved. Many other emotional issues have similarly dissolved since then.

    34 years later the depression and all the ancillary symptoms (chronic boredom, apathy, lost sense of humor, etc.) have never returned.

    • Beautifully said, Roger…

      The fact of the matter is that Ernst and his feeble-hearted followers only look at bumps in the road, rarely at the destination. Their reductionistic thinking and their scientism is evidence of an unhealthy and unscientific attitude that is wrapped in arrogance.

      • nice one, Dana – have you been on a ‘HOW TO INSULT THE MAXIMUM PEOPLE WITH ONE BIG MASTER-STROKE’- course?

      • @Dana I echo your sentiments (in highest potency)

        “The fact of the matter is that Ernst and his feeble-hearted followers only look at bumps in the road, rarely at the destination. Their reductionistic thinking and their scientism is evidence of an unhealthy and unscientific attitude that is wrapped in arrogance.”

        • To echo Dana’s comments in highest potency must mean, one imagines, that you have serially diluted and succussed them until there is no trace of them present…..

      • Oh look! Homeopathy’s toothless self-appointed attack-dog has popped up again to yap pointlessly and insignificantly at us. Got anything new to bring to the party, Dana, or are you going to stick with your usual demonstrations of your own stupidity?

    • When I said “improved diet”, it was actually improved diet with extensive high dose supplementation. This was after stopping the conventional meds that werent working. But of course we know that nutritional supplementation is a SCAM so I guess you can discount everything I said.

      • It is well established that conventional antidepressants work well in some cases and not at all in others. I don’t know, however, what research might be going on to establish whether there are markers (e.g. genetic variants) which might predict who will respond to what. This type of research is being carried out in many areas of medicine but psychiatry is not my field and I am not up to date with it. Of course antidepressants are not the only treatment used in conventional medicine. Surprisingly, ECT works very well in severe depression and can be life-saving. The downside is that it interferes with memory (it is performed under general anaesthetic so there is no awareness of the electric shock).

    • I’d compare it to tightrope walking — it’s difficult and possibly even pointless to learn, depending on what kind of a person one is, and what one makes of it. And obviously it can be dangerous too if it’s done at too great a height. And to push the metaphor further, sometimes people unwittingly are trying to do it over a deep hole.

      Asa with all alternative medicine, those trying to promote & profit from it refuse to see any of the dangers, and ascribe all possible benefits to it. But the brain and central nervous system are complicated, and tinkering with it is inherently dangerous.

      With meditation the risks are far more difficult to assess than with normal medicine, making it extremely hard to balance out the risks vs the possible benefits, (something alt-med fans also refuse to do).

  • Yes I agree that is it a scam and there are many others and more to come

  • apart from anecdote and a trial of n= 1 what evidence is there for treating depression with diet + “extensive high dose supplementation” (exactly what pray?)
    Equally can we take the “five 10-day Vipassana retreats” to be a minimum dose requirement? It seems to be very time consuming. Can atheists apply?

    Roger – you say your sense of humour has returned – are you certain? Have you read your own entries and those of Dana and Sandra? Just asking for a friend.

    I have a question for Dana – is it ethical to treat moderate to severe depression with homeopathy? Would it even be ethical to perform such a clinical trial with a placebo arm? It is a serious question.

  • @alan thornton

    “apart from anecdote and a trial of n= 1 what evidence is there for treating depression with diet + “extensive high dose supplementation” (exactly what pray?)”

    I wouldn’t sell short the idea of treating mental illness with diet + nutritional supplements. There are a group of MD’s that are treating a variety of mental illness by focusing on the vary thing you poo-poo. They don’t have actual studies, but I’d say treating and evaluating 33000 patients is more extensive than most studies.

    As it turns out, the imbalances thought to be related to “chemical imbalances” of the brain might be more correctly defined as metal imbalances. To be more specific, imbalances of copper and zinc. To be more specific again, could be a combination of too much or too little copper and/or zinc.

    Do some research, if your’re actually interested, I can point you in the right direction.
    Some folks here need to open their ears once in a while, and give a listen.

    BTW- I don’t care what type of medicine you want to label it…. Science based or Homeopathy. Labels are for soup cans.

    • “I don’t care what type of medicine you want to label it…. Science based or Homeopathy. Labels are for soup cans”.

      Well indeed, if you took all the labels off all the bottles of homeopathic 30C pills, no laboratory on earth would be able to tell you which was which.

      All the same, labels would be important to distinguish between Aconitum mother tincture and Aconitum 30C serial dilution. The effects on the body are likely to be very different.

      The anecdote regarding the five 10-day retreats and the high-dose ‘dietary’ supplementation is impossible to draw conclusions from, really. How are we to know what part the fifty days retreat played and how, and what minerals/vitamins etc were in the supplements, and how they interacted. Nothing can be concluded from that anecdote and if fact it well illustrates the lack of value of anecdotal reports.

      • @David B

        Don’t get me confused with Roger, not that I doubt his approach, I just can speak specifically for the therapy to which he speaks of.
        Mental health via biochemistry without psychotic meds is something that has been studied for decades, and is making solid advances today.

        https://www.walshinstitute.org/

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