Mindfulness Training Important Alternative to Psychiatric Medication

Again I have not been able to make it to the 2012 annual meeting of the American Psychiatric Association (APA), this year in Philadelphia. I have never been to an APA because I’m always on duty at that time of year as a psychiatric hospitalist. However, I do get to other meetings and I do get updates about the APA highlights. This one is about the value of Mindfulness practices, which are increasingly supported by research. Mindfulness practices can “offset the deleterious effects of stress or… prevent relapse in chronic recurrent depression…” and can lead to… “brain-structure alterations and genomic influences that add up to more equanimity, acceptance, and resilience when a patient faced with stressful situations. And when this happens, the impact on chronic conditions sensitive to stress is evident and measurable, especially in affective, anxiety, and character pathology.”

The results of a large randomized study found that compared with placebo, Mindfulness-Based Cognitive Therapy (MBCT) was as effective as maintenance antidepressant medication in unstable remitters. Some patients simply don’t want antidepressants and for a significant minority they can be dangerous, so MBCT may be a powerful alternative.

Mindfulness-Based Stress Reduction (MBSR) has been shown, after just an 8 week course, to change many aspects in the limbic (emotion-based) part of the brain compared with matched controls. These changes, which were noted in brain imaging, might point to enhanced emotion regulation, “thus leading to long-term changes in psychological health and well-being.”

Finally, something very interesting to many in our psychiatry department who are interested in genomics, there is “recent research showing that a range of mind-body practices had shared gene-expression profile changes. In a recent study, changes in pathways involved in immune regulation and mitochondrial energy metabolism were observed after an eight-week mind-body intervention that involved the elicitation of the relaxation response, a physiological state opposite of the fight-or-flight response. These findings raise the empowering notion that through behavior changes, individuals can impact their own genetic expression.”

If you want to learn more about the Mindfulness program at the University of Iowa Hospitals and Clinics, go to link Mindfulness Programs.