Mindfulness and Depression

The simplest definition of mindfulness is paying attention to one's experience in the present moment. It involves observing thoughts and emotions from moment to moment without judging or becoming caught up in them. Practitioners of mindfulness will, when the mind wanders, take note of where it goes, and calmly return to the moment at hand, perhaps focusing on breath, bodily sensations, or a yoga move.

Depression is not only the most common mental illness, it is also one of the most resistant to remission. Up to 80 percent of people who experience a major depressive episode may relapse. Drugs may lose their effectiveness over time. Worse, drugs may have no efficacy in a given patient.

Perhaps it is time to harness the power of mindfulness as treatment.

Mindfulness-based cognitive therapy (MBCT) has been shown to be effective at reducing the risk of relapse in patients with recurrent depression, especially in those with the most severe residual symptoms, a recent meta-analysis has shown.

MBCT seeks to teach people to disengage from the deeply ingrained dysfunctional thoughts that are common with depression.

Patients receiving MBCT had a significantly reduced risk of depressive relapse within a 60-week follow-up period compared with those who received usual care, Willem Kuyken, PhD, of the Warneford Hospital at Oxford University, and colleagues reported online in JAMA Psychiatry.

"While previous research has shown the superiority of MBCT compared with usual care, this study provides important new evidence that MBCT is also effective compared with other active treatments and that its effects are not restricted to particular groups defined by age, educational level, marital status, or sex," the researchers wrote.

Interestingly, they found that MBCT may be most helpful for patients with higher levels of depressive symptoms. In other words, the greater the risk for more refractory depression, the more benefit MBCT appears to offer.

Alas, although MBCT teaches patients at high risk of relapse how to minimize depressive symptoms, there is a gradual loss of effectiveness over time. Further, less severe patients may not derive as much benefit from MBCT when compared to those suffering more intense depression.

The analysis demonstrated that there was no statistically significant interaction with MBCT treatment between sociodemographic factors such as age, sex, education, and relationship status or psychiatric variables.

What remains to be determined is how to better utilize MBCT, and perhaps expand its utility in a condition where relapse is so common.