Meditation as effective as anxiety medication, study finds

The first study to directly compare medication to meditation for anxiety finds that both methods work equally well in reducing symptoms.

The finding, published Wednesday in the journal JAMA Psychiatry, suggests that people with anxiety could be helped by either a daily pill (which could have side effects) or a daily mindfulness practice (which requires a commitment from substantial time).

“For both treatments, we had people say, ‘It really worked,'” said study author Dr. Elizabeth Hoge, director of the anxiety disorders research program and associate professor of psychiatry at Georgetown University Medical Center in Washington, DC.

About 6.8 million adults in the United States have generalized anxiety disorder, but less than half receive treatment, according to the Anxiety & Depression Association of America.

The two-month study included 276 patients diagnosed with generalized anxiety disorder. Half received a common antidepressant – escitalopram (brand name: Lexapro) – and the other half participated in a mindfulness-based stress reduction program.

Both groups reported moderate improvements: a 20% reduction in symptoms at the end of the study, regardless of their treatment.

This kind of benefit is consistent with other studies of drugs to treat anxiety, said Craig Sawchuk, a psychologist at the Mayo Clinic in Rochester, Minnesota, who was not involved in the new research.

The study “shows that there are alternative options that don’t involve medicine to help treat anxiety that are just as effective,” said Lindsey McKernan, associate professor of psychiatry and behavioral sciences at Vanderbilt. University Medical Center in Nashville, Tennessee, which was also not involved in the study.

Side effects were more common in those receiving the antidepressant; almost 80% of participants experienced at least one side effect, such as trouble sleeping, nausea, headache, decreased sex drive and increased anxiety. Most were considered benign.

Only one side effect, increased anxiety, was reported in the mindfulness group, by about 15% of participants.

The mindfulness program, however, was time-consuming: Participants had to attend 2.5-hour group classes twice a week for eight weeks, plus a full day at a meditation retreat. Additionally, they were told to practice meditation for 45 minutes every day for the entire study period.

Hoge noted that after a six-month follow-up, 58% of people in the Lexapro group were still taking the drug, while only 28% of the meditation group were still practicing mindfulness at least four days a week.

It’s unclear why so many meditation participants seemed to give up, she said. They may no longer have symptoms or the time constraints are just too great.

“It might be easier to remember to take medicine once a day,” than to enroll in a 45-minute meditation, Sawchuk said.

However, the time spent in mindfulness throughout the study was important for people to learn the proper techniques, Hoge said. Mindfulness involves focusing on one thing, usually the breath or the sounds happening around you, and clearing the mind of other thoughts.

It’s hard to do for more than a few seconds before the mind wanders back to thinking about other things: to-do lists, assumptions, concerns about the future. Mindfulness teaches the brain not to be so overwhelmed by these intrusive thoughts.

The thinking behind mindfulness, Hoge said, is that it can make thoughts that fuel anxiety less powerful. She gave the example of someone worried about failing an exam. “Before the treatment, this thought makes them sweaty and nervous and they can’t think of anything else,” she said. “But the problem is just the thought itself, not the reality.”

Learning to accept such thoughts and move on “creates freedom,” Hoge said. “The thought arises, and it doesn’t have to take over the person.”

“It’s like helping you build a system where you can learn to react to stress instead of reacting to it,” McKernan said.

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