Had an exceptionally depressed day today, but in the spirit of my "I'm going to post even if I'm so depressed I'm not funny anymore" resolution, here is my post. And an emo picture to create the right atmosphere.
Today is one of those days when I am convinced I am using up other people's precious oxygen. When I wished I'd never met anyone so I wouldn't have to go through the hell of letting them down. Not meeting their expectations, you know? When you have a day where you can't even get in the shower, you are not going to be meeting anybody's expectations. Certainly 'my' body was expecting a shower. It's SOL.
Fine, enough of that. I didn't want to write about that. What I'd planned for today was to write some more about 'Mindfulness' (see my last post, Zen and the Art of Sanity Maintenance, if you don't know what I'm talking about.) So in spite of feeling like doo doo, I'm gonna write it. So there.
For example, one of the professional journals I'm reading with some consistency (because it is conveniently available from my psychologist) is Depression and Anxiety. In the in the June 2009 issue there is a paper entitled "Effectiveness of Mindfulness-Based Cognitive Therapy as an Adjuvant to Pharmacotherapy in Patients with Panic Disorder or Generalized Anxiety Disorder" by Kim et al. Yes, I read this for 'fun'. Can't help it. This is what grad school did to me.
As I mentioned, I originally got pointed towards mindfulness when I heard about it as part of a treatment for BPD. That treatment is DBT (Dialectical Behavioral Therapy.) But there are a slew treatments now being implemented for issues across the board including mindfulness-based stress reduction (MBSR), acceptance and commitment therapy (ACT) and mindfulness-based cognitive therapy (MBCT). MBCT is the one that has most recently caught my eye because (as noted here in this 2009 paper), it was originally used to "target cognitive vulnerabilities associated with the repeated relapse and recurrence of major depressive disorder". Something that is being used in both depression and anxiety therapy seems like a direct hit for me.
In the research described in this paper, they actually excluded those with comorbid depression since they just wanted to see how the MBCT did with 'pure anxiety'. They put some of their people through an MBCT program, and some through a basic ADE program (basic education in what anxiety and panic are, how they function biologically, etc.) They made a point of making sure the ADE group did not do any mindfulness related work. Both programs lasted for eight weeks. At the end of that time they used a standard criterion for 'anxiety remission' to see if there was a difference between the groups. Of course, a study is only as good as their criterion for judging differences, but researchers are stuck with using whatever is documented and reasonably reproducible. I won't quibble with their definition of 'remission'.
Anyway, they had 16 people in the MBCT group meet the criterion for remission after eight weeks, and none in the ADE group. Hardly a surprise for the poor ADE people, since I hardly stopped having panic attacks myself just because I learned what they were. But having sixteen people go into 'remission' from a group of say 30 to 40, and after only eight weeks of MBCT, sounds very interesting.
They also happened to check the MBCT group's before and after scores on certain depression indicators. Which sort of makes no sense since they were trying to eliminate that variable. Anyway, their MBCT group showed significantly more improvement on those scales than the ADE group, as well.
So the upshot of the paper, which is consistent with almost all the other research I have read, is that "MBCT reduces anxious and depressive symptoms in patients with PD or GAD by moderating worry and rumination." They also state, which may be a little bit of a reach, that "these results are consistent with previous studies which concluded that meditation can reduce phobic and obsessive-compulsive symptoms."
It sounds a bit too good to be true. Reminds me of all that past broo-ha-ha surrounding anti-depressant medications like Prozac. The magic bullet. Har.
Still, I'm now several weeks into my own Zen meditation class, and it certainly isn't doing me any harm. I haven't been doing anything as structured as a full up MBCT program, so I can hardly expect to note 'results' of my own by now. But I have gone ahead and bought the book "The Mindful Way Through Depression" by Williams et al. so I can take a closer look at MBCT.
I'll report back on that when I've run more experiments on myself. I wonder if anyone will publish that paper?
Your Hostess with Neuroses
Image is "With Messy Hair" by nyki_m on Flikr via Creative Commons
Wednesday, August 19, 2009
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