Stuart J. Eisendrath MD

When Antidepressants Aren’t Enough

Mindfulness

How Does Mindfulness Help With Depression and Anxiety?

New research helps explain the power of mindfulness in dealing with emotions.

Posted Oct 10, 2019

Antidepressants: The good and the bad.

The history of antidepressant response became clearer with the STAR*D study starting in 2006. It revealed that up to 50% of individuals receiving antidepressants achieved remission after 24 weeks of two medication trials. Unfortunately, that left 50% who had not. We wanted to improve on that number and help those who were still suffering despite two or more medication trials.

To respond to this problem, I led the Practicing Alternatives to Heal Depression Study sponsored by the National Institutes of Health. We found that mindfulness had powerful effects in reducing depression and anxiety. It also helped increase self-compassion while reducing ruminations.  Ruminations are endless loops of thoughts that increase depression while not helping to find solutions to troublesome situations.

Mindfulness as a useful modality for mood regulation.

Mindfulness at its core is being aware of your experiences as you are experiencing them and suspending judgment about them. These include sensations, thoughts, and feelings. Mindfulness meditation can be thought of as shining the spotlight of attention on a specific focus that you select in the present moment. This spotlight can be as broad or narrow as you like. Typically, mindfulness can be thought of in two ways. In one, the discrete form, you practice focusing your attention for a specific amount of time, say a meditation where you focus on your breath for 10 minutes. When your mind wanders, you notice the wandering and bring the attention back to the breath. In the other form of mindfulness, it can be called dispositional mindfulness where you bring mindful awareness to your everyday life. For example, you notice the sensations in your feet as you walk down the street. In both forms of mindfulness, you are focusing your awareness but the settings differ.

Mindfulness mechanisms in depression  

Depression and anxiety can be thought of as disorders of time. In depression, you are focused on the past. You feel as if a loss has already occurred—e.g. lost loved one, relationship, job, or valued object. With anxiety, you feel as if a loss is going to occur in the future—a catastrophe is looming. Mindfulness has powerful antidepressant and antianxiety effects because its focus is on the present moment. When you focus on the present moment, you let go of the past and the future. If you are focused on your body sensations you aren’t focusing on the past or future.

Mindfulness meditation does not require a big-time commitment.

If you can breathe, you can be mindful. Mindfulness is a skill like others. When you start learning to build your muscles, you start with small weights and gradually increase them. The same approach applies to mindfulness. You start with short meditations and then learn to vary the types of meditations you do. Many people find that short meditations—say five to 10 minutes a day—are easiest to do while other people prefer a 30-minute meditation. There is no evidence that a specific amount of time is necessary to learn mindfulness skills. Rather, it is important for you to develop your own regular, ideally daily, the practice of what works for you.

Learn more about mindfulness for mood here.

References

Eisendrath, S (2019). When Antidepressants Aren't Enough:  Harnessing the Power of Mindfulness to Alleviate Depression. Novato, CA: New World Library.