Mindfulness as effective as drugs at treating anxiety

Bruce Banner is famously bad at controlling his emotions. That’s kind of his whole deal, but in 2008 The Incredible Hulk, he makes a real effort to control his feelings. We see him withdraw from his former life and take up meditation and yoga. As a result, he hasn’t had a Hulk-like outburst in five months. There’s a lot about the Marvel Universe that strains credulity, but this isn’t one of them.

For centuries, cultures around the world have understood the benefits of mindfulness and meditation. Now, the scientific literature is accumulating to support the practice. In July of this year, scientists used mindfulness training to reduce physical pain in human patients, and new research suggests it may be just as good at dealing with psychological pain. That’s according to a study published in the journal JAMA Psychiatrywhich used mindfulness as an alternative treatment for anxiety disorders.

The researchers recruited 430 study participants, including 276 adults with diagnosed anxiety disorders, of whom 208 completed the study. Participants were given blinded assessments at the beginning of the study, eight weeks later when the active part of the study ended, and then assessments at 12 and 24 weeks. The idea was to assess whether, and to what extent, mindfulness practice reduces anxiety symptoms and how it compares to conventional drug treatments.

The Eternal Sunshine of the Spotless Mind

The participants were divided into two groups, approximately one to one. One group received escitalopram, commonly known as Lexapro, flexibly dosed between 10 and 20 milligrams depending on the person. The second group completed a mindfulness-based stress reduction course that included two-and-a-half-hour classes once a week and 45 minutes of daily practice at home. During those sessions, participants learn to pay attention to their bodies and focus on what is happening in the moment rather than what might happen in the future. When intrusive thoughts arise, they train themselves to acknowledge them briefly and then put them aside. It is believed to help train a person to detach from their emotional state and take control of their feelings.

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Both groups received the full assessment package, which assessed anxiety levels using the Clinical Global Impression of Severity Scale. During the baseline assessment, before any intervention, the mindfulness group had a CGI-S score of 4.44 while the medication group had a score of 4.51. For reference, a score of one indicates no illness at all, while a score of seven indicates extreme illness. Both groups hovered around four and a half, between “moderately ill” and “markedly ill”. This was to be expected, the groups were randomly selected and should have had results that were more or less the same before the intervention. The question was whether alertness would be maintained until treatment with medication to reduce anxiety levels.

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After eight weeks, participants received their second evaluation, and scores were increased over baseline for both groups. The awareness group saw an average score decrease of 1.35 while the CGI-S score for the medication group decreased by an average of 1.43. That left the mindfulness and drug groups with scores of 3.09 and 3.08 respectively, on average, just above “mildly ill” on the CGI-S scale. In short, they found that mindfulness is comparably effective as frontline drug therapies for treating anxiety.

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Additionally, of the patients who started treatment, 10 of the drug group dropped out because of adverse effects, while none of the attention patients did. This is the first head-to-head comparison of mindfulness and medication and supports the argument for mindfulness and meditation as alternative or complementary therapies for anxiety disorders.

Full disclosure: some of the mindfulness patients reported increased anxiety, despite the overall decline. Like most treatments for mental illness, your mileage may vary. It’s also worth noting that not everyone has access or bandwidth to hours of mental health interventions every week. Currently, there are no data on whether these results will extend to telehealth or app-based care. Of course, there is one way to find out, at least anecdotally. Spend some time with yourself today and see if mindfulness is right for you.

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