Mindfulness-based therapy can be an effective treatment/treatment adjunct for depressed patients who don’t respond to medication or traditional forms of therapy. Research may show that there are actually physical brain changes in people who engage in mindfulness therapy. More studies are needed to see if these findings are generalizable.

The NIMH (National Institute of Mental Health) estimates that about 7.1% of the American population has had at least one major depressive episode. This disease can be debilitating; and for a percentage of sufferers, the depression may be resistant to first-line antidepressants and traditional therapy. A new form of therapy that has gained press recently, known as “mindfulness therapy,” may help those with treatment-resistant depression.

Mindfulness therapy is rooted in meditative practice and the concept of “interoception,” where clients “focus their attention on the here and now” and their internal states. Meditators learn to concentrate on their bodies (namely their breathing or heartbeat), as well as any physical sensations they note. Researchers at Harvard Medical School are examining whether patients who engage in this practice are able to more easily “break the cycle of self-rumination” and negative self-talk that is prevalent in depression. Physical changes are also being noticed in the brains of meditators. fMRI (functional MRI) is a form of brain imaging that shows the brain itself, as well activity in certain brain regions.

Depressed patients at baseline have been shown to have an over-activation of the amygdala (the brain’s fear response center), and some even show overall brain thinning. Early findings on fMRI are promising, showing 1) decreased activation of the amygdala and 2) thickening of the brain in clients who have participated in a 2-month meditative practice. These physical changes on fMRI could point to mindfulness-based therapy as an effective form of treatment for patients who don’t respond to first-line therapies. More research is needed to validate mindfulness as a generalizable form of treatment.

Cal Psychiatry physicians are well-versed in treating depression (including treatment resistant depression). We can help you decide if medication and/or therapy are right for you and can even help you incorporate some mindfulness techniques into your daily life.

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