• Posted November 10, 2022

Mindfulness Program Equals Antidepressants in Easing Anxiety Disorders

A new study harnesses the power of mindfulness to help overanxious people calm themselves -- and the benefit may equal the use of an antidepressant, according to researchers at Georgetown University Medical Center in Washington, D.C.

Olga Cannistraro said practicing mindfulness certainly helped her. "There was something excessive about the way I responded to my environment," she explained.

Cannistraro, now 52, decided to join a study on mindfulness-based stress reduction (MBSR) for anxiety disorders 10 years ago. The study was led by Dr. Elizabeth Hoge, who directs the Anxiety Disorders Research Program at Georgetown.

MBSR "gave me the tools to spy on myself," Cannistraro explained in a center news release. "Once you have awareness of an anxious reaction, then you can make a choice for how to deal with it. It's not like a magic cure, but it was a lifelong kind of training. Instead of my anxiety progressing, it went in the other direction and I'm very grateful for that."

The latest study by Hoge's team seems to confirm those earlier, positive results. Published Nov. 9 in JAMA Psychiatry, the study recruited 276 people with anxiety disorder who were seeking treatment at hospitals in Boston, New York City and Washington, D.C. All were offered either the SSRI antidepressant escitalopram (brand name Lexapro, commonly used to treat anxiety) or eight weeks of MBSR.

The mindfulness classes were given weekly and lasted 2.5 hours. People using MBSR were also sent on a weekend mindfulness retreat at about week 5 or 6 of the program. They were also asked to do daily 45-minute practices at home.

Participants' anxiety levels were assessed prior to enrollment in the study and then again at completion (eight weeks later). They got follow-up assessments 12 and 24 weeks later, as well.

Professionals who conducted the assessments were not told whether the person had undergone the MBSR program or had simply taken the antidepressant. Participants' anxiety was graded on a standard 7-point scale, with 7 representing severe anxiety levels. The people enrolled in the study had an average anxiety score of 4.5, Hoge's team said.

Both methods of anxiety reduction seemed to help. Folks who took the antidepressant saw their anxiety scores drop by an average of 1.46 points, while those taking MBSR got an average 1.35-point reduction, which the researchers say is a statistically equivalent benefit. The point drop equals about a 30% decline in anxiety scores.

Anxiety levels remain high for many Americans, the Georgetown team noted. In fact, on Oct. 11 the United States Preventive Services Task Force -- an influential panel of independent experts -- recommended screening for anxiety disorders for the first time.

Of course, mindfulness programs such as the one used in the new study cost money.

"Our study provides evidence for clinicians, insurers and health care systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders because mindfulness meditation currently is reimbursed by very few providers," Hoge said in the release.

"A big advantage of mindfulness meditation is that it doesn't require a clinical degree to train someone to become a mindfulness facilitator," she noted. "Additionally, sessions can be done outside of a medical setting, such as at a school or community center."

While antidepressants can be effective in easing excess worry, they can sometimes be tough for patients to access or they may come with side effects ranging from sexual dysfunction, nausea or drowsiness.

And meditation is entering the mainstream: By 2017, according to the researchers, 15% of Americans said they'd tried the practice.

Still, MBSR might not be for everyone, Hoge added.

"Not everyone is willing to invest the time and effort to successfully complete all of the necessary sessions and do regular home practice which enhances the effect," she said.

For those who can't attend classes in person, "virtual delivery via videoconference is likely to be effective, so long as the 'live' components are retained, such as question-and-answer periods and group discussion," Hoge said.

The effectiveness of virtual delivery of MBSR for anxiety disorders is now being studied by the same group of researchers.

More information

Find out more about anxiety disorders at the American Psychiatric Association.

SOURCE: Georgetown University Medical Center, news release, Nov. 9, 2022