Mindfulness-based therapy could offer an alternative to antidepressants for preventing depression relapse
by Thom Bush
on 21 April 2015
Anxious_Woman

Having had a family history, as well as a personal experience of depression, I guess gives me some insight into what it feels like, that said, depression is a very subjective experience! From a therapeutic perspective talking therapy has a long history of effectively helping sufferers, so any corroborative research can only help in an understanding of the treatment regimes and their effectiveness!

I essentially look at two ways of living, 1/ "brain living" and 2/ "mind living". Brain living occurs when we leave the task of everyday life to our brain. The structure of brain function dictates that the past is a precursor of the future and how you coped yesterday will, most likely, work today and tomorrow. However, often, the way we cope is not what I would term living, it is just getting by. Sometimes coping can be deleterious to effective living, in that it actually does more harm than good or just works against our better interests. Mind living however, is very different and involves the effective use of positive thought and positive language, both internal and external, difficult to explain briefly. Positive language could also be considered as language without ambiguity or vagueness!

Essentially language is an interface between thought and emotion. The way we speak influences emotion and behaviour and the way we behave influences the way we think and speak. I guess you can now understand the theory as to how mindfulness makes a change to how we think? People with depression rarely have an existential experience of life but rather; think they have no control over their life or future.

Anyway, I thought the research below may be helpful to anyone who suffers with or knows someone with depression!

The results come from the first ever large study to compare MBCT -- structured training for the mind and body which aims to change the way people think and feel about their experiences -- with maintenance antidepressant medication for reducing the risk of relapse in depression.
The study aimed to establish whether MBCT is superior to maintenance antidepressant treatment in terms of preventing relapse of depression. Although the findings show that MBCT isn't any more effective than maintenance antidepressant treatment in preventing relapse of depression, the results, combined with those of previous trials, suggest that MCBT may offer similar protection against depressive relapse or recurrence for people who have experienced multiple episodes of depression, with no significant difference in cost.
"Depression is a recurrent disorder. Without ongoing treatment, as many as four out of five people with depression relapse at some point," explains Willem Kuyken, lead author and Professor of Clinical Psychology at the University of Oxford in the UK.
"Currently, maintenance antidepressant medication is the key treatment for preventing relapse, reducing the likelihood of relapse or recurrence by up to two-thirds when taken correctly," adds study co-author Professor Richard Byng, from the Plymouth University Peninsula Schools of Medicine and Dentistry, UK. "However, there are many people who, for a number of different reasons, are unable to keep on a course of medication for depression. Moreover, many people do not wish to remain on medication for indefinite periods, or cannot tolerate its side effects."
MBCT was developed to help people who have experienced repeated bouts of depression by teaching them the skills to recognise and to respond constructively to the thoughts and feelings associated with relapse, thereby preventing a downward spiral into depression.
In this trial, which was conducted from the University of Exeter, UK, 424 adults with recurrent major depression and taking maintenance antidepressant medication were recruited from 95 primary care general practices across the South West of England. Participants were randomly assigned to come off their antidepressant medication slowly and receive MBCT (212 participants) or to stay on their medication (212 participants).
Participants in the MBCT group attended eight 2 ¼ hour group sessions and were given daily home practice. After the group they had the option of attending 4 follow up sessions over a 12 month period. The MBCT course consists of guided mindfulness practices, group discussion and other cognitive behavioural exercises. Those in the maintenance antidepressant group continued their medication for two years.
All trial participants were assessed at regular intervals over 2 years for a major depressive episode using a psychiatric diagnostic interview tool -- the Structured Clinical Interview for DSM-IV.
Over 2 years, relapse rates in both groups were similar (44% in the MBCT group vs 47% in the maintenance antidepressant medication group). Although five adverse events were reported, including two deaths, across both groups, they were not judged to be attributable to the interventions or the trial.
According to study co-author Professor Sarah Byford, from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London, UK, "As a group intervention, mindfulness-based cognitive therapy was relatively low cost compared to therapies provided on an individual basis and, in terms of the cost of all health and social care services used by participants during the study, we found no significant difference between the two treatments."
According to Professor Kuyken, "Whilst this study doesn't show that mindfulness-based cognitive therapy works any better than maintenance antidepressant medication in reducing the rate of relapse in depression, we believe these results suggest a new choice for the millions of people with recurrent depression on repeat prescriptions. "*
Study participant Mr Nigel Reed from Sidmouth, Devon, UK, comments that, "Mindfulness gives me a set of skills which I use to keep well in the long term. Rather than relying on the continuing use of antidepressants mindfulness puts me in charge, allowing me to take control of my own future, to spot when I am at risk and to make the changes I need to stay well."
Writing in a linked Comment, Professor Roger Mulder from the University of Otago in New Zealand says, "Because it is a group treatment that reduces costs and the number of trained staff needed, it might be feasible to offer [mindfulness-based cognitive therapy] as a choice to patients in general practice…We therefore have a promising new treatment that is reasonably cost effective and applicable to the large group of patients with recurrent depression."
Story Source: http://www.ibtimes.co.uk/depression-mindfulness-therapy-eff…