Mindfulness exercises can be just as effective as anxiety medications, research shows


Practice mindfulness to relieve anxiety may be just as effective as medication, new research shows.

A recent study published in JAMA Psychiatry found that people who received eight weeks of mindfulness-based interventions experienced a decrease in anxiety similar to those who were prescribed escitalopram, a common anti-anxiety drug often prescribed under the brand name Lexapro.

A seven-point scale was used to rate anxiety among 208 participants, with a score of seven representing extreme anxiety and a score of one representing normal. In both the medication and mindfulness groups, the mean score decreased after treatment from moderate anxiety level to mild anxiety level.

Both groups entered the study with similar baseline scores (4.44 in the mindfulness group and 4.51 in the medication group). By the end of the study, anxiety scores had dropped to an average of 3.09 on the anxiety scale in both groups, a statistically similar change that showed that the treatments were equally effective.

Mindfulness practices such as breathing exercises have long been used to treat anxiety, but this is the first study to show how effective they can be compared to standard treatments for anxiety disorders, said the study’s lead author, Elizabeth Hoge, who is a psychiatrist and director. from the Anxiety Disorders Research Program at Georgetown University.

She believes the findings support the use of mindfulness as a viable intervention that may be better than traditional treatments for some people, such as those who are uncomfortable going to a psychiatrist or who experience negative side effects from medication.

“We can’t yet predict who will do better with what type of treatment,” Hoge said. “But there’s nothing to say you couldn’t do both at the same time.”

Breathing, body scans and conscious movement

Mindfulness treatments used in the study included breath awareness exercises, in which you pay attention to your breath as you allow thoughts to arise and then move through your mind before releasing them. Importantly, the practice isn’t about trying to change your breath, Hoge said, but about focusing on your breathing as a way to ground yourself when anxious thoughts arise.

Participants also completed exercises such as a body scan, which pays attention to different parts of the body, and mindful movement, which stretches the body into different positions and notes how each movement feels.

Those who received the eight-week mindfulness intervention attended a weekly 2.5-hour class with a mindfulness teacher, completed daily home exercises for 45 minutes, and attended a one-day mindfulness retreat five or six weeks after the course.

When fear becomes a habit

The reason mindfulness can help with anxiety is that it can interrupt a negative feedback loop in the brain, says Jud Brewer, director of research and innovation at Brown University’s Mindfulness Center and chief medical officer at Sharecare, a digital health company. Brewer believes that fear is a habit driven by negative reinforcement in the brain.

When we have a situation or thought causes our anxiety, worrying about it can be rewarding in the brain, he said. “It can give people a sense of control, even though they don’t have more control than they would if they weren’t worried,” Brewer said.

Trying to stop worrying using willpower doesn’t work, he said, because it doesn’t change the way your brain works. But mindfulness can help your brain learn new habits because it helps you recognize that worrying isn’t rewarding and provides an alternative sense of control that feels better than worrying, Brewer said. He helped develop a mindfulness training app called Unwinding Anxiety and showed in a small, randomized study that using the app significantly reduced anxiety in people.

How mindfulness can change the brain

Other studies have shown that practicing mindfulness can rewire the brain, leading to long-term changes in behavior and thinking, said Sara Lazar, an associate professor at Harvard Medical School.

In people who worry a lot, a part of the brain called the default mode network can become overactive, causing their minds to drift more often to negative or anxious thoughts, Lazar said. But research shows that meditation and mindfulness exercises can help turn off this part of the brain and make it less active by training people to refocus, she explained.

Mindfulness training has also been shown to reduce activity in the amygdala, a part of the brain that helps regulate anxiety, stress and other emotions, she said. And her research suggests that these kinds of changes can be long-lasting.

“People who go through these programs continue to report benefits months later, even when they quit,” Lazar said. “It’s like learning to ride a bike. Even if you stop, you can do it again.”

Gripped by anxious thoughts

Julie Rose, 48, of Provo, Utah, decided to try mindfulness in 2018 when she realized that while medications helped with her anxiety, she needed additional coping strategies. She found it difficult to concentrate on her work as a podcast host and had trouble sleeping. Her anxious thoughts “grabbed” her, she said, and trying to control them by ignoring them or redirecting her anxious energy didn’t help.

She signed up for eight weeks of mindfulness classes. At first she didn’t feel like the breathing or body awareness exercises were working – she still had anxious thoughts and felt she couldn’t calm them down.

After a few weeks, she realized that while she couldn’t stop her anxious thoughts with meditation, she could acknowledge them in a way that they passed. easier and faster. On days when she meditated, she slept better and felt better overall, she said.

“I used to think this was stupid, but it really works,” she said. “It allows the fear to keep going through me.”

How to practice mindfulness for anxiety

The more someone practices mindfulness, the more they’ll benefit, but even doing a few short exercises a few times a week can reduce anxiety, said Katherine Cullen, a licensed psychotherapist with Juniper Therapeutic Services in New York. Although many studies of mindfulness involve a greater time investment for eight weeks, Cullen often suggests her patients start small with a simple two-minute breathing exercise a few times a week.

She said mindfulness practices can feel uncomfortable at first because people aren’t used to dealing with their emotions or anxious thoughts.

‚ÄúThink of it as sports. You could go for a walk after being inactive for a while and it might feel uncomfortable,” she said. “The key, as with exercise, is to be consistent with it.”

If anyone is interested in trying mindfulness exercises, she advised that they should not change their medication without consulting their prescribing physician or psychiatrist, and that they should seek out a practitioner or coach certified in Mindfulness Based Stress Reduction, which is is an evidence based one. form of mindfulness training. People can also look for centers affiliated with the nonprofit, Buddhist organization Insight Meditation Society, many of which offer donation-based mindfulness classes.

“If you’re new to mindfulness and have never done it before, I would strongly encourage you to do it with someone else,” Cullen said. “It’s very helpful to have someone there to actively walk you through it and answer all your questions.”

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