From primary care doctors and psychiatrists to health and wellness professionals, opinions vary greatly on the effectiveness of antidepressants. Some believe they’re essential medications, while others think they’re no better than a sugar pill.
New research indicates behavioral changes may be as effective as antidepressants in treating anxiety. A recent study showed mindfulness to be as effective at reducing anxiety as the leading selective serotonin reuptake inhibitors (SSRIs). For severe depression and anxiety, SSRIs and other medications are vital, but for the more moderate to mild cases, mindfulness meditation is showing promising results.
To understand how mindfulness may help with anxiety and depression and to provide an overview of the latest research on the efficacy of SSRIs, Mindfulness Strategies analyzed the most current research on the topic.
Please Note: The content on MindfulnessStrategies.com is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment. If you’re experiencing a medical emergency, call 911 immediately.
The Latest Findings
A recent study published in the Journal of the American Medical Association (JAMA) revealed that mindfulness may be as effective at reducing anxiety as escitalopram, better known as Lexapro. This randomized clinical trial of 276 adults with anxiety disorders showed that an 8-week treatment with mindfulness-based stress reduction was non-inferior to a daily course of 10 to 20 milligrams (mg) of escitalopram.
This study adds to the American Journal of Nursing’s finding from 2011, which found meditation to be as effective as antidepressants in preventing recurrent depression.
In an interview with CNN Health, Elizabeth Hoge, the lead researcher in the JAMA study, noted that meditation could be prescribed instead of medication. This would be a big win for patients who experience severe side effects or allergies to anti-anxiety drugs, or patients who dislike taking medications.
With a growing body of research highlighting the successes of mindfulness interventions, insurance companies may be willing to reimburse for meditation courses in the same way they currently reimburse for prescription medications.
Don’t Stop Taking Your Medications Yet
The new research doesn’t mean patients should discontinue prescribed medications. Severe side effects can occur when SSRIs and other anxiety medications are discontinued. Symptoms of anxiety and/or depression can worsen and “brain zaps,” headaches, and vomiting can occur.
Patients also need to consider their current lifestyle and time commitments. In the JAMA study, patients assigned to the meditation group were asked to attend a weekly, in-person, two-and-half-hour-long mindfulness meditation group class. In conjunction with this class, they were asked to meditate on their own for 40 minutes a day. These daily and weekly commitments are important considerations when thinking about prescribing mindfulness as a treatment modality. For some patients, “microdosing” mindfulness can be extremely helpful when time becomes a limiting factor.
Finally, depression and anxiety can range from mild or moderate to severe. For patients with moderate to severe depression and/or anxiety, meditation alone is unlikely to successfully treat the condition. However, it is worth consulting your doctor if you’re interested in treatment options. Meditation and other mindfulness practices can be used very successfully in conjunction with medication.
The Power of the Mind and Body
Most psychiatrists assert that medication is necessary for people with severe depression and anxiety. However, growing research suggesting relief from mild to moderate depression and anxiety is actually due to the placebo effect.
In a recent Institute for Quality and Efficiency in Health Care (IQWiG) study, researchers found the more severe a patient’s condition, the greater the benefits of medication. Simply put: Antidepressants are effective against chronic, moderate, and severe depression and are unlikely to help with mild depression. That said, the study noted that in most trials, 20 to 40 percent of people with severe depression who took a placebo noticed an improvement in their symptoms within six to eight weeks.
Additionally, studies suggest about half of the people currently taking antidepressants could stop without relapsing into depression. However, to be fair, it's nearly impossible to tell who will respond positively to medication and who won't.
What’s disconcerting for many people is the fact that doctors are still unsure exactly how or why SSRIs work.
For this reason, many psychiatrists have started taking a non-pharmaceutical, holistic approach to treatment. They look into daily habits such as sleep, diet, and exercise, and recommend behavioral changes (like therapy) and meditation.
Considering Meditation as a Treatment
Anxiety occurs throughout the course of life as a normal and healthy response to life stressors. It's perfectly normal to feel uneasy, worried, or restless in certain life situations. When these feelings become chronic, unmanageable and/or severe, it may indicate a more serious problem..
If you're interested in trying medication alternatives such as mindfulness, it's critical to keep your doctor informed. The emerging research is incredibly promising, however, medical professionals must be involved in the process whenever treatment options and plans are being considered or modified.
If you’re interested in learning more about mindfulness, please visit our blog for more resources and information.