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Mindfulness
What's the Evidence for Mindfulness for Depression?
Mindfulness therapies have much to offer for depression, if we use them wisely.
Posted July 26, 2024 Reviewed by Abigail Fagan
Key points
- Mindfulness-based therapies are increasingly used for many conditions, including depression.
- Systematic evidence supports mindfulness-based therapies for preventing relapse of depression.
- Every person’s experience of mindfulness is different, so treatment must be personalised to each individual.
Mindfulness means paying attention to the present moment, as simply and directly as possible. It involves developing a careful, curious awareness of the sensations, thoughts, and emotions that are present, but not changing or judging them.
Mindfulness means staying focussed on the present moment as much as possible, and when the mind wanders, gently re-directing it back to direct sensations: the feeling of your feet on the floor, the texture of a book in your hands.
The idea of mindfulness is rooted in Buddhist and early Hindu psychology. It forms a key part of meditative practices in both traditions. It is an ancient art that also echoes through other psychological and spiritual traditions, many of which incorporate some form of contemplative practice or prayer.
Does mindfulness help prevent relapse in depression?
Over recent decades, mindfulness has become part of therapeutic approaches to a range of mental illnesses and psychological symptoms. There is now compelling evidence that particular courses of mindfulness-based therapies, provided over an eight-week period, help to prevent relapse in depression. Data to support this approach have accumulated rapidly but steadily in recent times.
In 2021, one summary of research about mindfulness-based cognitive therapy (MBCT) for prevention and time to relapse of depression strongly supported MBCT over treatment as usual (TAU). The authors concluded that “MBCT is more effective than TAU in the long-term in preventing relapse of depression and has statistically significant advantages over TAU and placebo for time to relapse of depression”.
Everyone is different
Learning the skills of mindfulness and how to apply them is clearly a powerful technique for preventing relapse in depression, albeit that this practice does not appeal to everyone. Some people prefer other forms of psychotherapy or medication, so it is vital to understand each person’s experiences of mindfulness before, during, and after treatment.
In 2022, one study sought to summarize research about the experiences of people with depression who took part in MBCT. How, exactly, did MBCT help them?
These authors found that “participants became skilled through engagement in mindfulness practices, reporting increased awareness, perspective and agency over their experiences. Participants developed acceptance towards their experiences, self and others. There was variability and ambivalence regarding participants’ expectations and difficulties within mindfulness practices”.
Mindfulness: a victim of its own success
Despite compelling evidence to support mindfulness-based interventions, mindfulness has become a victim of its own popularity. Misleading versions of mindfulness are often presented as simple solutions to complex problems, or as easy ways to side-step challenging interpersonal issues that need to be addressed.
These misrepresentations are regrettable. Mindfulness is a very useful tool but is not the answer to everything. While more research is needed in certain areas, various levels of evidence now support mindfulness-based psychological therapies for some people with mild and moderate depression, anxiety disorders, self-harming behavior, substance misuse, obsessive-compulsive disorder, and eating disorders.
These conditions can be difficult to treat in practice, so any new therapies which are supported by evidence are welcome.
Mindfulness in medicine
Mindfulness can help to promote holistic health in chronic medical illness, deepen psychological care during cancer treatment, and assist in terminal care settings. There is particular evidence of benefit in depression, pain conditions, smoking, and various addictive disorders.
Finally, for some people without psychological problems or mental illness, mindfulness can offer a powerful way to improve general psychological wellbeing. The benefits of mindfulness can be subtle but profound, once mindfulness is practiced with diligence, care, and commitment.
We need to practice mindfulness mindfully.
References
Kelly BD. The Modern Psychiatrist’s Guide to Contemporary Practice: Discussion, Dissent, and Debate in Mental Health Care. New York and London: Routledge, 2024 https://www.taylorfrancis.com/books/oa-mono/10.4324/9781003378495/modern-psychiatrist-guide-contemporary-practice-brendan-kelly).
McCartney M, Nevitt S, Lloyd A, Hill R, White R, Duarte R. Mindfulness-based cognitive therapy for prevention and time to depressive relapse: systematic review and network meta-analysis. Acta Psychiatrica Scandinavica 2021; 143: 6-21 (https://doi.org/10.1111/acps.13242) (Link to license: https://creativecommons.org/licenses/by/4.0/).
Williams K, Hartley S, Langer S, Manandhar-Richardson M, Sinha M, Taylor P. A systematic review and meta-ethnographic synthesis of mindfulness-based cognitive therapy for people with major depression. Clinical Psychology and Psychotherapy 2022; 29: 1494-1514 (https://doi.org/10.1002/cpp.2773) (Link to license: https://creativecommons.org/licenses/by/4.0/).
Segal Z, Williams M, Teasdale J. Mindfulness-Based Cognitive Therapy for Depression (Second Edition). New York and London: The Guilford Press, 2018.
Goldberg SB, Tucker RP, Greene PA, Davidson RJ, Wampold BE, Kearney DJ, Simpson TL. Mindfulness-based interventions for psychiatric disorders: a systematic review and meta-analysis. Clinical Psychology Review 2018; 59: 52-60 (https://doi.org/10.1016/j.cpr.2017.10.011).
