Mindfulness meditation may ease fatigue, depression in multiple sclerosis

In the study, people who took an eight-week class in mindfulness meditation training reduced their fatigue and depression and improved overall quality of life compared to people with MS who received only usual medical care. The positive effects continued for at least six months.

"People with MS must often confront special challenges of life related to profession, financial security, recreational and social activities, and personal relationships, not to mention the direct fears associated with current or future physical symptoms and disability. Fatigue, depression and anxiety are also common consequences of having MS." said study author Paul Grossman, PhD, of the University of Basel Hospital in Switzerland. "Unfortunately, the treatments that help slow the disease process may have little direct effect on people's overall quality of life, fatigue or depression. So any complementary treatments that can quickly and directly improve quality of life are very welcome."

For the study, 150 people with mild to moderate MS were randomly assigned to receive either the eight-week meditation training or only usual medical care for MS. The class focused on mental and physical exercises aimed at developing nonjudgmental awareness of the present moment, or mindfulness. The training included weekly classes lasting two and a half hours, plus one all-day retreat and 40 minutes per day of homework assignments.

"MS is an unpredictable disease," Grossman said. "People can go for months feeling great and then have an attack that may reduce their ability to work or take care of their family. Mindfulness training can help those with MS better to cope with these changes. Increased mindfulness in daily life may also contribute to a more realistic sense of control, as well as a greater appreciation of positive experiences that continue be part of life."

Participants in the mindfulness program showed extremely good attendance rates (92%) and reported high levels of satisfaction with the training. Furthermore, very few (5%) dropped out of the course before completion. Those who went through the mindfulness program improved in nearly every measure of fatigue, depression and quality of life, while those who received usual medical care declined slightly on most of the measures. For example, those with mindfulness training reduced their depressive symptoms by over 30 percent compared to those with no training.

Improvements among mindfulness participants were particularly large for those who showed significant levels of depression or fatigue at the beginning of the study. About 65 percent of participants showed evidence of serious levels of depression, anxiety or fatigue at the start of the study, and this risk group was reduced by a third at the end of training and six months later.

The other benefits of the training were also still apparent six months after the training ended, although they were sometimes reduced compared to right after finishing the training. Reductions in fatigue, however, were stable from the end of treatment to six months later.

An accompanying editorial pointed out that because there was not an active control group (using a different type of intervention), it is unclear that the good results were specifically a result of mindfulness training. However, the editorialists noted that the present study was the largest of its type, and was well-conducted.

The study was supported by the Swiss National Science Foundation, the Stanley T. Johnson Foundation, the Swiss Multiple Sclerosis Foundation, Sanofi-Aventis, Merck Serono and Biogen Dompé.