
Mindfulness therapy as good as medication for chronic depression – study - bsbechtel
http://www.reuters.com/article/2015/04/20/us-health-depression-idUSKBN0NB2KO20150420
======
falcolas
Important note - the participants had already displayed relapses from
medication based treatments, so they were already in a position where
medication was not filling their needs.

[https://www.plymouth.ac.uk/news/mindfulness-based-therapy-
co...](https://www.plymouth.ac.uk/news/mindfulness-based-therapy-could-offer-
an-alternative-to-antidepressants-to-prevent-depression-relapse)

I was unable to find the paper in Lancet's online system.

~~~
shasta
Erm, so the summary is that if medicine doesn't work for you then mindfulness
therapy may work just as well as medicine?

~~~
LegendaryPatMan
TL;DR is that if medicine fails you, mindfulness is better than random chance
of getting better

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BadassFractal
As far as I can tell that's pretty much what the book Feeling Good concluded
many years ago:
[http://en.wikipedia.org/wiki/Feeling_Good:_The_New_Mood_Ther...](http://en.wikipedia.org/wiki/Feeling_Good:_The_New_Mood_Therapy)
, except at the time it was called Cognitive Behavioral Therapy. It's
fascinating how the book dodges mentioning meditation as much as possible, but
as you read it, you realize it's essentially proposing the same exact
techniques of insight, just in a more clinical terminology.

~~~
empressplay
CBT differs in two ways: First, it tends to be more reactive in that you
typically analyse troublesome thoughts after-the-fact rather than in the
present, as they happen. Second, it tends to be more ego-centric in that it
tends to focus exclusively on your thoughts and needs, whereas mindfulness is
more compassionate, both to yourself and to those you interact with. So, while
there are similarities there are also important differences.

And while meditation is good for practicing mindfulness "in slow motion", you
don't _need_ to meditate to be mindful.

~~~
greenjellybean
>And while meditation is good for practicing mindfulness "in slow motion", you
don't _need_ to meditate to be mindful.

Yes!! If you wake up and just don't feel like meditating that day, then don't!
I view meditation as a tool that helps you reach deep into mindfulness, but
meditating to meditate is missing the point. The goal you should have is to be
mindful/present in the moment throughout the day.

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INTPenis
It's funny how this article is being spun by different sources.

Just the title being slightly different is enough to put a different
interpretation on it. For example Reuters writes that "mindfulness is as good
as medication".

But a Swedish doctors journal[2] writes "MBCT not better than
pharmaceuticals".

And they both cite the same source[1].

[1]:
[http://www.thelancet.com/journals/lancet/article/PIIS0140-67...](http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2962222-4/abstract)
[2]: [http://www.lakartidningen.se/Klinik-och-vetenskap/Nya-
ron/20...](http://www.lakartidningen.se/Klinik-och-vetenskap/Nya-
ron/2015/04/KBT-inte-battre-an-farmaka-vid-recidiverande-depressioner/)

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nicholaides
The article just publishing a press release.

 _" Treatment usually involves either medication, some form of psychotherapy
or a combination of both. Yet many patients fail to get better and suffer
recurring bouts of illness.

"MBCT was developed to help such people by teaching them skills to recognize
and respond constructively to thoughts and feelings associated with relapse,
aiming to prevent a downward spiral into depression."_

This implird that MBCT is better than medication and/or psychotherapy, but
later it says that it's just as (in)effective as medication, and also doesn't
seem to realize that MBCT IS a form a psychotherapy.

 _" teaching them skills to recognize and respond constructively to thoughts
and feelings associated with relapse, aiming to prevent a downward spiral into
depression."_

A lot of forms of psychotherapy do this. Some, do it explicitly, like CBT.
Some do it implicitly, like psychoanalysis.

The important thing that the article leaves out (or that the study was unable
to demonstrate) is how well it compares to other forms of psychotherapy in
treating depression.

So in conclusion, what we know from this paper, is only, psychology should
continue the course it's on: treat depression with a combination of medication
and psychotherapy, and MBCT is a valid option.

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heimatau
I can see how this is effective. I remember reading that people with chronic
depression have better memories and dwell on the past. Getting the person
focused on the present could, theoretically, help alleviate painful memories.
More studies need to be done. I'm all for natural, non-medicated, means of
cures.

~~~
teacups
I have chronic major depressive disorder. I don't think I have a better
memory, maybe I have a predisposition to remember things that feel bad to me.
Repeating the same loop in one's mind is not necessarily intelligent, nor does
it indicate anything about memory, aside from the mind that clings
continuously to a given idea.

~~~
tehchromic
but maybe you do have a better memory! which is why it is so difficult to
forget things that feel bad. Leaving aside the question of intelligence, which
is so many things that it isn't worth judging any individual by it, I would
say your statement supports both the idea that memory is related to
depression, and that focusing on the art of creation of new, positive
memories, is a path to happiness, for people like you and me. As a person with
a damn good memory, who once felt like you do, cheers!

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gesman
Millions of dollars are made and will be made with the help of the statements
starting from, or ending with the word: "study" (possibly preceded with the
word "independent").

Study -> implies authority -> implies ability to manipulate.

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pella
research paper:

 _" Effectiveness and cost-effectiveness of mindfulness-based cognitive
therapy compared with maintenance antidepressant treatment in the prevention
of depressive relapse or recurrence (PREVENT): a randomised controlled trial"_

[http://www.thelancet.com/journals/lancet/article/PIIS0140-67...](http://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(14\)62222-4/fulltext)

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rrss1122
After reading the article and the comments here, I have mixed reactions to
this.

As I have learned more about anti-depressants, I've come around to the opinion
that they are no more effective than placebo at treating mental illness. The
fact that mindfulness therapy is "as good as medication" tells me that
mindfulness therapy isn't very useful either. What it does make me think is
just the act of being treated helps. Awareness of mental illness and pushing
people to seek any treatment then seems to be preferable to doing nothing at
all.

I'd still hedge my bets and choose some form of therapy over messing with the
chemical system in my brain. I personally have experience with CBT and have
great results, but in addition to that there is Mindfulness-based Cognitive
Therapy (MBCT) and other forms of clinical therapy designed to treat mental
illness that someone can try if CBT doesn't work for them.

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bakhy
So, there was no third group, a group taken off meds and then put on no
therapy whatsoever, to represent a baseline? Perhaps that would be unethical.
I'm just curious how high the relapse rate would be in that group.

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joeyspn
350 Million people with depression is a bigger number than I previously
thought... I wonder if this technique (MCBT) could somewhat be implemented in
a mobile app that assists/guides you during the day...

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Karunamon
I'd personally take this with a grain of salt - if I recall correctly, the
effectiveness of antidepressant medication is roughly equal to that of random
chance.

Yeah.. high 40's percent relapse rate in the article.

~~~
DanBC
Take what with a pinch of salt? That MCBT is about the same as meds for
chronic recurrent depression? Because the paper appears to show that it is as
effective. Or that it works at all? Well, they didn't have a group that they
took off medication and who didn't do therapy so we don't know what the
relapse rate would have been for that group. I suspect that t would be higher
than 45%

~~~
cpncrunch
You also should remember that the placebo effect does actually contribute a
large part of the effect of antidepressants. The research just shows that
antidepressants don't have much of an effect _above and beyond_ placebo.

I see therapy as being more useful and reliable in the long term than a
placebo.

~~~
DanBC
> The research just shows that antidepressants don't have much of an effect
> above and beyond placebo

For mild depression. For moderate depression they're better. For severe
depression they're better when you get the right one.

An evidence based therapy is always a good idea.

~~~
cpncrunch
I just did a search and came across this meta-analysis, which confirms your
statement:

[http://jama.jamanetwork.com/article.aspx?articleid=185157](http://jama.jamanetwork.com/article.aspx?articleid=185157)

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LunaSea
Breathing as good as medication for life.

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hitlerwasright
This isn't really news, though it speaks more to the limited use of the
current psychiatric doping paradigm than the efficacy of mindfulness.

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marincounty
"Mindfulness-based cognitive therapy - study"

Well, if drugs are only slightly better than placebo, and that's for the
sickest patients maybe you shouldn't use it as a marker anymore? And that
efficacy number is so low; it's wispered, and some clinicians after looking at
the studies/metadata cannot even say drugs work over placebo in clinical
depression.

(sorry for being so dismissive--just tired of these "studies" that leave out
the fact that so many drug/depression studies were poorly done, manipulated,
cherry picked, didn't exclude early placebo responders, done in 3rd world
countries for the cheapest price(no real oversight, lying, etc.), and we were
essentially lied to---)

~~~
mkehrt
The ineffectiveness of drugs against depression is highly overstated--the
average effectiveness is low, but the variance is high, and they tend to be
more effective the more severe the depression. The meme of "drugs aren't
actually effective against depression" isn't doing the people for whom do work
any favors.

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alexryan
Mindfulness is BETTER than drugging yourself because it enables you to not
only hold the unskillful emotional state in mindful awareness and disperse it
at will, but it also enables you to discover the unskillful patterns of
thinking that give rise to this state to begin with.

With mindfulness you can completely eradicate these unskillful patterns of
thinking from your life forever and replace them with more empowering
patterns.

There is no better investment that you can make than to invest a little bit of
your time learning how to be mindful. The rewards are extraordinary.

Here in the bay area a great class is offered at the Insight Meditation Center
in Redwood city: [http://www.insightmeditationcenter.org/programs/for-
beginner...](http://www.insightmeditationcenter.org/programs/for-beginners/)

~~~
Snesker
As I read this comment I thought it was a shill piece and you proved me right
with the link at the end. I was about to say that if you want to exploit the
gullible here, do it less transparently but you more or less got it right.

~~~
alexryan
As I read this comment I thought of a mind which habitually creates a reality
of powerless victimhood so pervasive that it perceives bad intentions on the
part of everyone and feels compelled to lash out at perceived threats that
don't even exist. This is the product of an unskillful pattern of thinking.
You can either go deeper into hell until you pop yourself or correct it.

