Mindfulness as effective as pills for treating recurrent depression

[Olm the Water King]

Mindfulness as effective as pills for treating recurrent depression - study | Society | The Guardian

Mindfulness as effective as pills for treating recurrent depression - study

Medical best practice is for people with history of depression to take antidepressants for two years – but cognitive therapy may be equally effective

Mindfulness-based cognitive therapy may be as good as pills at stopping people relapsing after recovering from major bouts of depression, according to a study.

Mindfulness-based cognitive therapy (MBCT) was developed from mindfulness techniques, which encourage individuals to pay more attention to the present moment, combined with cognitive behaviour therapy (CBT), specifically to try to help people who have recurring depression.

It teaches people to recognise that negative thoughts and feelings will return, but that they can disengage from them. Rather than worrying constantly about them, people can become aware of them, understand them and accept them, and avoid being dragged down into a spiral leading back to depression.

Current best practice, endorsed by Nice (the National Institute for Health and Care Excellence) is to encourage people with a history of recurrent depression to remain on antidepressants for at least two years.

However, some are very reluctant to keep taking pills, while others find their depression comes back when they finally stop using the tablets.

The trial, published in The Lancet, a medical journal, involved a group of 424 adults from GP practices in the south-west of England, who were willing to try either the pills or the therapy. Half were randomly allotted to each. Those assigned to mindfulness had eight group sessions of more than two hours plus daily home practice and the option of four follow-up sessions over a year. The course involved mindfulness training, group discussion and cognitive behaviour exercises. The patients gradually came off their medication. Those assigned to the other group stayed on the tablets for two years.

The relapse rates in the two groups were similar, with 44% in the mindfulness group and 47% for those on the drugs. In each group there were five adverse events, including two deaths.

The researchers had thought the study might show that therapy was more effective than pills, based on their earlier work. Lead author Willem Kuyken, a professor of clinical psychology at the University of Oxford, said: “That was our hypothesis. It was based on our pilot study in 2008. There was a suggestion that MBCT might do better than medication. The reality is that it was not superior to medication.”

However, they established that mindfulness-based therapy is equally as good as drugs, which could offer a new option for those who do not want to be on medication for years. Co-author Prof Richard Byng, from the Plymouth University Peninsula Schools of Medicine and Dentistry, said: “Currently, maintenance antidepressant medication is the key treatment for preventing relapse, reducing the likelihood of relapse or recurrence by up to two-thirds when taken correctly.

“However, there are many people who, for a number of different reasons, are unable to keep on a course of medication for depression. Moreover, many people do not wish to remain on medication for indefinite periods, or cannot tolerate its side-effects.”

Nigel Reed, from Sidmouth, Devon, who took part in the trial, said: “Mindfulness gives me a set of skills which I use to keep well in the long term. Rather than relying on the continuing use of antidepressants, mindfulness puts me in charge, allowing me to take control of my own future, to spot when I am at risk and to make the changes I need to stay well.”

The study also showed that the therapy might work better than pills for those who have some of the most troubled histories and are at the highest risk of relapse. It was found to have protected people with increased risk because of a background of childhood abuse. The paper said: “Perhaps MBCT confers resilience in this group at highest risk because patients learn skills that address some of the underlying mechanisms of relapse or recurrence.”

Kuyken said he expected Nice to look at the study when it convenes shortly to revise its guidelines on recurrent depression.

In a commentary with the study in The Lancet, Prof Roger Mulder, from the University of Otago in New Zealand, said the findings had substantial significance. He suggested that because it is group therapy, which reduces the costs involved, it may be possible to offer MBCT as a choice to GP patients. He said: “We ... have a promising new treatment that is reasonably cost-effective and applicable to the large group of patients with recurrent depression.

“Depression remains a disabling condition with high prevalence and a large clinical burden. Despite the increased use of drugs, the long-term outcome of mood disorders has not improved in the modern era. Having an alternative non-medication strategy to reduce relapse is an important means to help patients with depression.”

 

[Great Architect]

My only thing about this is that I sometimes wish people could want this for something deeper (seems to be self help oriented, but what about self development?). but if it can allow people to experience a different quality of human experience, which will make this world a better place, and get people off of medication, as their body has its own regulatory system, which can be worked with, if one is willing to learn their body, than it can only be a gain. The article doesnt seem to give any methods on how to practice it. So my question is, how does one become open to the present moment, and be able to return to it?

 

[Jet Stream]

THE most effective depression curing tool is daily cardio because over time it can combine a similar chemical release achieved through pills and a similar peace of mind achieved through mindfulness. The only problem is it can be inconvenient and require more willpower to stick to than both quick fix methods mentioned by the OP.

 

[ygolo]

I've been trying the mindfulness practice for a while. It has been definitely more effective for me than medication alone.




Unfortunately, that's not high praise.

 

[Yama]

I'm not doubting its effectiveness, I just wanted to say... easier said than done. But, I think that mindfulness and medication together would be more effective than one over the other.

 

[windoverlake]

Epigenetics

Grandma's Experiences Leave Epigenetic Mark on Your Genes | DiscoverMagazine.com

 

[kyuuei]

My only thing about this is that I sometimes wish people could want this for something deeper (seems to be self help oriented, but what about self development?). but if it can allow people to experience a different quality of human experience, which will make this world a better place, and get people off of medication, as their body has its own regulatory system, which can be worked with, if one is willing to learn their body, than it can only be a gain. The article doesnt seem to give any methods on how to practice it. So my question is, how does one become open to the present moment, and be able to return to it?

It doesn't give methods because, honestly, that's just not the aim for the article. But. Cognitive Therapy Treatment for Depression: Techniques & Benefits Here's a start for the very basics of cognitive therapy. Usually, from my experience, what happens is a therapist listens to a person talk, and catches all sorts of keywords and things people don't even realize they're using. Like always/never fallacies and such. And it gets guided and more focused from there.

The reality is people cannot develop when they're just trying to survive. Survive, then thrive. Another reality is not everyone's bodies are healthy, or in good working condition. And sometimes life just isn't so bright and sunny for others and every day is a real struggle and depression is absolutely warranted. It's great that you want people to have a great quality of life, a lot of people do.. but it's baby steps one day at a time. And for some depression is such a deeply rooted issue that they'll spend their whole lives barely managing it at best.

THE most effective depression curing tool is daily cardio because over time it can combine a similar chemical release achieved through pills and a similar peace of mind achieved through mindfulness. The only problem is it can be inconvenient and require more willpower to stick to than both quick fix methods mentioned by the OP.

Depression is not an illness that gets 'cured'. It is a management based disorder. Cardio has been proven in many studies to be effective at helping with depression, that is very true. But to say this is the single most effective tool known to modern medicine is grossly misunderstanding the dynamics of the disorder. Plenty of in-shape people suffer from depression. This is a very complex thing, it cannot be looked at through such a narrow scope.

I'm not doubting its effectiveness, I just wanted to say... easier said than done. But, I think that mindfulness and medication together would be more effective than one over the other.

Definitely a combination. The cool thing about it is that it's (somewhat) free to use after you get a good foundation for it all. Groups can actually get together and support each other with cognitive behavioral therapy stuff.

But +1 at the easier said than done thing. Everyone's so quick to just start humping all of the webmd stuff they see and vomit it onto peoples' laps. "Just run! Just drink gluten free ginger fennel tea! Just think about like happy stuff!" Definitely it is a harder thing.. telling someone to run when they *just* lost their leg seems so impossible in that moment.. People want to just stop bleeding and get a grip on reality first. But once they have that grip, this can be an option to keep them from stagnating, and lift them up and keep them up.

What I find really interesting about cognitive therapy is that it helps people who don't even have issues. Almost everyone can benefit from this sort of therapy in their own individual lives. Which makes me believe this helps improve one's quality of life, and so indirectly improves depression as a result. Changing the way one thinks is very difficult.. but with practice and time, it can happen, and I think many many people are in denial about needing a change in attitude. Which is ironic since people want people with depression to flip it off again like a light switch.

I always tell people to think of it like this: Try to imagine the guy with the mole on his face from Austin Powers without being the 'mole' guy. It is very difficult to unlearn it. It's always been there, and it's always been that way.. the center of the entire character and joke. There is no other way to think about it at first. You have to REALLY try hard to unlearn the fact there's a huge mole there. You have to create a whole 'nother character to remove that one mole and that stupid "moley moley moley!" line.

 

[Jet Stream]

It doesn't give methods because, honestly, that's just not the aim for the article. But. Cognitive Therapy Treatment for Depression: Techniques & Benefits Here's a start for the very basics of cognitive therapy. Usually, from my experience, what happens is a therapist listens to a person talk, and catches all sorts of keywords and things people don't even realize they're using. Like always/never fallacies and such. And it gets guided and more focused from there.

The reality is people cannot develop when they're just trying to survive. Survive, then thrive. Another reality is not everyone's bodies are healthy, or in good working condition. And sometimes life just isn't so bright and sunny for others and every day is a real struggle and depression is absolutely warranted. It's great that you want people to have a great quality of life, a lot of people do.. but it's baby steps one day at a time. And for some depression is such a deeply rooted issue that they'll spend their whole lives barely managing it at best.



Depression is not an illness that gets 'cured'. It is a management based disorder. Cardio has been proven in many studies to be effective at helping with depression, that is very true. But to say this is the single most effective tool known to modern medicine is grossly misunderstanding the dynamics of the disorder. Plenty of in-shape people suffer from depression. This is a very complex thing, it cannot be looked at through such a narrow scope.



Definitely a combination. The cool thing about it is that it's (somewhat) free to use after you get a good foundation for it all. Groups can actually get together and support each other with cognitive behavioral therapy stuff.

But +1 at the easier said than done thing. Everyone's so quick to just start humping all of the webmd stuff they see and vomit it onto peoples' laps. "Just run! Just drink gluten free ginger fennel tea! Just think about like happy stuff!" Definitely it is a harder thing.. telling someone to run when they *just* lost their leg seems so impossible in that moment.. People want to just stop bleeding and get a grip on reality first. But once they have that grip, this can be an option to keep them from stagnating, and lift them up and keep them up.

What I find really interesting about cognitive therapy is that it helps people who don't even have issues. Almost everyone can benefit from this sort of therapy in their own individual lives. Which makes me believe this helps improve one's quality of life, and so indirectly improves depression as a result. Changing the way one thinks is very difficult.. but with practice and time, it can happen, and I think many many people are in denial about needing a change in attitude. Which is ironic since people want people with depression to flip it off again like a light switch.

I always tell people to think of it like this: Try to imagine the guy with the mole on his face from Austin Powers without being the 'mole' guy. It is very difficult to unlearn it. It's always been there, and it's always been that way.. the center of the entire character and joke. There is no other way to think about it at first. You have to REALLY try hard to unlearn the fact there's a huge mole there. You have to create a whole 'nother character to remove that one mole and that stupid "moley moley moley!" line.

Nah it can be curable. It's just so taboo to say that it's almost not even worth it. Forget I mentioned it...not in the mood to have crusaders like you pounce on me for my politically incorrect yet all around positive outlook on this matter.

 

[á´…eparted]

Nah it can be curable. It's just so taboo to say that it's almost not even worth it. Forget I mentioned it...not in the mood to have crusaders like you pounce on me for my politically incorrect yet all around positive outlook on this matter.

It's not a positive outlook, it's patently false as just a pair of rose colored glasses. There isn't a cure for depression, period. kyuuei already explained how and why so I am not going to bother rexplaining it. In some individuals, it's transient and will go away on its own or with some aid. In others, it's life long and no amount of therapy of all kinds can remedy it. In those cases it can only be managed.

 

[Jet Stream]

It's not a positive outlook, it's patently false as just a pair of rose colored glasses. There isn't a cure for depression, period. kyuuei already explained how and why so I am not going to bother rexplaining it. In some individuals, it's transient and will go away on its own or with some aid. In others, it's life long and no amount of therapy of all kinds can remedy it. In those cases it can only be managed.

Rose colored glasses is just a gloomy way of saying ignoring the problem with an iron will until it escapes one's consciousness. Idk why pretty much all people are so opposed to this. It doesn't work because nobody wants it to work, nobody trusts simple solutions, it's like it's always gotta be some tedious journey with all kinds of complications. So frustrating.

 

[á´…eparted]

Rose colored glasses is just a gloomy way of saying ignoring the problem with an iron will until it escapes one's consciousness. Idk why pretty much all people are so opposed to this. It doesn't work because nobody wants it to work, nobody trusts simple solutions, it's like it's always gotta be some tedious journey with all kinds of complications. So frustrating.

There is no credible substantiating medical evidence to support your claims. I actually find it to be incredibly insulting to insinuate that individuals with depression could be "cured" just because you think it could be.

 

[Jet Stream]

There is no credible substantiating medical evidence to support your claims. I actually find it to be incredibly insulting to insinuate that individuals with depression could be "cured" just because you think it could be.

Medical evidence is often nothing more than propaganda to further the financial interests of the wicked drug pushing pharmaceutical industry. Didn't mean to insult you or anyone else though, sorry.

 

[á´…eparted]

Medical evidence is often nothing more than propaganda to further the financial interests of the wicked drug pushing pharmaceutical industry. Didn't mean to insult you or anyone else though, sorry.

Ah, paranoia and conspiracy theories. Completely unsubstantiated. Your opinions are completely meaningless and nothing more than hot air. I've met others like you in this regard many times in the past and there is no reasoning with these people as the reject the very foundations that are required for a meaningful discussion. As such your assertions in this thread are to ignored.

I was not insulted, I was insulted on behalf of others. You didn't mean it, but you did. That doesn't make it any better.

 

[Jet Stream]

Ah, paranoia and conspiracy theories. Completely unsubstantiated. Your opinions are completely meaningless and nothing more than hot air. I've met others like you in this regard many times in the past and there is no reasoning with these people as the reject the very foundations that are required for a meaningful discussion. As such your assertions in this thread are to ignored.

I was not insulted, I was insulted on behalf of others. You didn't mean it, but you did. That doesn't make it any better.

No I truly didn't don't tell me what my intentions were please. And ignore this if you like, but I don't think my assertions are unsubstantiated. Billion dollar industry, tons of drugs on the market, many addictive, easy for the depressed and vulnerable to get prescriptions, encouraged strongly by doctors, quick fix solution, leads to greater problems down the road, more prescriptions, more money, extended prescriptions, extended cashflow. I can't think of a more detailed way to explain it.

edit: oh never mind you realized my intentions but were being critical of the results of my words. Gotcha. Well, to that I say nobody should be insulted. I'm being pretty helpful in my opinion.

 

[kyuuei]

Nah it can be curable. It's just so taboo to say that it's almost not even worth it. Forget I mentioned it...not in the mood to have crusaders like you pounce on me for my politically incorrect yet all around positive outlook on this matter.

I'm not derailing an entire thread for manipulative language and dismissive aggressive tones.. But the point of the thread is to talk about *treatments for depression*. Dismissing the whole thread by saying "Oh there's a cure so you don't need any treatments" is annoying, and completely off topic. Attacking me as a 'crusader' for trying to gently push the topic back on track and clarifying the issue at hand won't change that.

I'm sure you think you're being very optimistic, but your statements are extremely dismissive and quite rude, particularly to people on here which do suffer from clinical depression or have loved ones who do.

I was going to go into depth about how we don't even know all the sources of depression or what truly causes it.. but given your immediate distrust of modern medicine I'll settle for this: the same studies and science that were used to give you the evidence for running helping depression are also used for my statements too.. so take that for what you will.

If you want to talk about the merit of running versus cognitive therapy for treatment options, and you'd like to compare evidence for them, then that'd be something constructive.. but otherwise, you're literally walking in here, throwing attacks out, and getting defensive when people bite back.

 

[Cellmold]

Grandma's Experiences Leave Epigenetic Mark on Your Genes | DiscoverMagazine.com

This explains my love of cats & malteasers. And my fear of Germans.