Meditation for anxiety, depression?

"A lot of people use meditation, but it's not a practice considered part of mainstream medical therapy for anything," says Madhav Goyal, M.D., M.P.H., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine and leader of a study published online Jan. 6 in JAMA Internal Medicine. "But in our study, meditation appeared to provide as much relief from some anxiety and depression symptoms as what other studies have found from antidepressants." These patients did not typically have full-blown anxiety or depression.

The researchers evaluated the degree to which those symptoms changed in people who had a variety of medical conditions, such as insomnia or fibromyalgia, although only a minority had been diagnosed with a mental illness.

Goyal and his colleagues found that so-called "mindfulness meditation" -- a form of Buddhist self-awareness designed to focus precise, nonjudgmental attention to the moment at hand -- also showed promise in alleviating some pain symptoms as well as stress. The findings held even as the researchers controlled for the possibility of the placebo effect, in which subjects in a study feel better even if they receive no active treatment because they perceive they are getting help for what ails them.

To conduct their review, the investigators focused on 47 clinical trials performed through June 2013 among 3,515 participants that involved meditation and various mental and physical health issues, including depression, anxiety, stress, insomnia, substance use, diabetes, heart disease, cancer and chronic pain. They found moderate evidence of improvement in symptoms of anxiety, depression and pain after participants underwent what was typically an eight-week training program in mindfulness meditation. They discovered low evidence of improvement in stress and quality of life. There was not enough information to determine whether other areas could be improved by meditation. In the studies that followed participants for six months, the improvements typically continued.

They also found no harm came from meditation.

Meditation, Goyal notes, has a long history in Eastern traditions, and it has been growing in popularity over the last 30 years in Western culture.

"A lot of people have this idea that meditation means sitting down and doing nothing," Goyal says. "But that's not true. Meditation is an active training of the mind to increase awareness, and different meditation programs approach this in different ways."

Mindfulness meditation, the type that showed the most promise, is typically practiced for 30 to 40 minutes a day. It emphasizes acceptance of feelings and thoughts without judgment and relaxation of body and mind.

He cautions that the literature reviewed in the study contained potential weaknesses. Further studies are needed to clarify which outcomes are most affected by these meditation programs, as well as whether more meditation practice would have greater effects.

"Meditation programs appear to have an effect above and beyond the placebo," Goyal says.