Effective Stress Reduction and Anxiety Disorder Treatment without Antidepressants

A Georgetown University Medical Center randomised clinical trial found that mindfulness-based stress reduction is just as effective in treating anxiety disorders as a typical antidepressant medication.

Credit goes to : forbes.com

When it comes to treating anxiety disorders, mindfulness-based stress reduction is just as effective as antidepressants.

For patients with anxiety disorders, a guided mindfulness-based stress reduction programme was just as successful as the gold-standard medication, the widely used antidepressant medicine escitalopram. According to the findings of a groundbreaking, randomised clinical trial directed by scientists at Georgetown University Medical Center, this is the case.

Because mindfulness meditation is currently reimbursed by very few providers, the study provides evidence for clinicians, insurers, and healthcare systems to recommend, include, and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders, according to Elizabeth Hoge, MD, director of the Anxiety Disorders Research Program and associate professor of psychiatry at Georgetown University and first author. The fact that mindfulness facilitator training does not necessitate a clinical degree is a significant benefit of mindfulness meditation. Sessions may also take place somewhere else, such a community centre or a school, besides a hospital.

Anxiety disorders, which include generalised anxiety, social anxiety, panic disorder, and phobias of specific environments or circumstances, such as crowds and public transit, can be extremely distressing. All of them are frequently treated in psychiatric clinics since they all raise the risk of suicide, impairment, and distress.

The currently prescribed medications for the illnesses can be highly successful, but many patients find it difficult to obtain them, do not respond to them, or feel that the side effects (such as nausea, sexual dysfunction, and drowsiness) prevent them from receiving consistent therapy.

Anxiety can be decreased by standardised mindfulness-based techniques like mindfulness-based stress reduction (MBSR). However, the therapies hadn’t been compared to potent anti-anxiety medications before this trial. It should be noted that roughly 15% of Americans tried meditation in 2017.

Between June 2018 and February 2020, the doctors enrolled 276 patients from three hospitals in Boston, New York City, and Washington, D.C. The patients were then randomly randomised to receive either mindfulness-based stress reduction or the antidepressant medication escitalopram. A two-and-a-half-hour in-person class, a day-long retreat class on the weekend during the fifth or sixth week, and daily home practise exercises were all used to provide MBSR over the course of eight weeks. The severity of the patients’ anxiety symptoms was evaluated prior to enrolment, at the end of the intervention at 8 weeks, and again at 12 and 24 weeks after enrollment. The evaluations were carried out in a blinded way, meaning that the qualified clinical evaluators were unaware of whether the patients they were evaluating had received the medication or MBSR.

At the conclusion of the trial, 102 patients had finished the MBSR, and 106 had finished their prescribed medication. The patients were 156 women, who made up 75% of the registrants, and had a median age of 33, echoing the disease incidence in the United States.

On a scale of 1 to 7, the researchers utilised a validated evaluation tool to rank the intensity of anxiety symptoms across all illnesses (with 7 being severe anxiety). Both groups experienced a decrease in their anxiety symptoms (a mean reduction of 1.35 points for MBSR and a mean reduction of 1.43 points for the drug, which was a statistically equivalent result), dropping from a mean of about 4.5 for both, which corresponds to a significant decrease in anxiety severity of about 30%.

The practise of MBSR, according to 52-year-old Olga Cannistraro, changed her life more than ten years ago. She now uses it as needed. After replying to an advertising asking, “Do you worry?” she was chosen for an MBSR study.

When she looks back, she says, “I didn’t think of myself as anxious — I just believed my life was hectic because I had taken on too much.” “But I acknowledged that I worried. There was something over the top about how I reacted to my surroundings.

She gained knowledge of two essential MBSR strategies after taking part in an earlier study conducted by Hoge. “I have the means to spy on myself thanks to it. A decision on how to handle an anxious reaction can be made once you are aware of it. Although it wasn’t a quick fix, the training was ongoing. I’m very thankful that my anxiety went the other way rather than getting worse.

It’s crucial to remember that while mindfulness meditation has benefits, not everyone is ready to put in the time and effort required to finish all required sessions and engage in consistent at-home practise, which heightens the benefits, according to Hoge. As long as the “live” elements are kept, such question-and-answer sessions and group discussions, virtual delivery through videoconference is also likely to be successful.

Hoge notes that there are numerous smartphone apps that provide guided meditation, but scientists are unsure of how these apps stack up against the entire in-person, weekly group class experience.

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