Mindfulness for Depression – What’s the Evidence?

Depression can feel like a huge, frightening forest in which you are lost. Everything has disappeared into the fog: friends, family, the delicious taste of Hawaiian pizza, sleep. The paths are overgrown and everything looks the same. Worst of all is the feeling of complete isolation.

But even in the darkest corner, it’s possible that a hand will be extended to you from the outside, helping you to view the forest from a distance. The tall trees are no longer so threatening, and here and there you can make out small clearings and paths. How is this change in perspective possible? In this article, you’ll learn how mindfulness can support you in finding a way out of depression.

Mindfulness as an alternative to antidepressants?

While some celebrate mindfulness as a welcome alternative to Western medicine, others dismiss the Far Eastern import as snake oil. As so often, the truth is probably somewhere in the middle. The big question is therefore: How and under what circumstances does mindfulness help with depression?

In severe and chronic depression, you can imagine the forest described at the beginning as a veritable jungle. Antidepressants and psychotherapy are then the common treatment of choice to clear the overgrown paths and trails. For mild depression, however, clinical studiescould not establish a clear effect of medication treatment. [1] [1] How effective are antidepressants?: Institute for Quality and Efficiency in Health Care (IQWiG): Health information Mindfulness-based methods are therefore available as an alternative – and you don’t risk any physical side effects either. 

Around 10 to 15% of patients discontinue treatment with antidepressants prematurely due to side effects such as headaches, weight gain, or sexual dysfunction. [2] [2] How effective are antidepressants?: Institute for Quality and Efficiency in Health Care (IQWiG): Health information Since depression should under no circumstances go untreated, mindfulness can be a sensible “Plan B” if you don’t tolerate the medication. What is important is a treatment that corresponds to what you really need now and that you can cope with. After all, depression itself already contributes enough to your personal discomfort.

How does mindfulness work against depression?

We are used to curing illnesses with pills or operations. That’s why it initially sounds like a bad joke to counteract the biochemical imbalance of depression through conscious breathing in the lotus position. According to Cambridge Professor John Teasdale, the Far Eastern practice works mainly for the following reasons: [3] [3] Interview: PsychCentral (2018): How does Mindfulness reduce Depression?

Depression, that would mean above all: brooding, thinking, worrying, and brooding a little more. Negative thoughts cost energy, like an electrical appliance on perpetual standby, Teasdale explains. In mindfulness exercises, you focus your attention on other things, such as your breath. By diverting your attention away from the stream of negative thoughts, they lose their power.

Many sufferers also complain that they are too much “in their heads”. They would like to stop the carousel of thoughts and stop overthinking everything. Mindfulness refers to being present in the moment, to the here and now in your body and the physical world around you. This can be the scent of flowers, the smooth surface of the wooden table, or the muscles in your body. Ruminating on the past or brooding about the future find no room when you direct your entire attention to the present.

Teasdale further explains that mindfulness helps you gain distance. By seeing yourself as an observer, you create distance between yourself and your negative emotions and are no longer overwhelmed by them. Viewed from a little distance, even depression is “merely” an unhealthy behavioural pattern, a bad habit, like automatically reaching for a cigarette – but not part of your personality.

How mindful are you? Here is the mindfulness test

MBSR for depression

Probably the best-known of the mindfulness-based methods is Mindfulness-Based Stress Reduction (also known as MBSR) by Jon Kabat-Zinn. The programme includes various forms of meditation such as breathing exercises or the relaxation technique of the body scan.

Since MBSR is a clinically recognised method, it is also the most frequently found in studies and has so far been considered more effective than other mindfulness exercises such as progressive muscle relaxation by Jacobson or autogenic training. [4] [4] Study: US National Library of Medicine National Institutes of Health (2017): Mindfulness-Based Interventions for Anxiety and Depression However, your own perception is more important than study results. So listen closely to yourself and notice what personally does you good.

MBCT as relapse prevention

Just as a forest keeps overgrowing, depression is also a stubborn weed: eight out of ten patients experience relapses. Therefore, prevention is an essential part of treatment. In medication treatment, this means for patients, however, that they must continue to take antidepressants for six months to two years after the symptoms have subsided. 

For this reason, the already mentioned psychologist Teasdale developed Mindfulness-Based Cognitive Therapy (also known as MBCT). MBCT is a cognitive behavioural therapy that is combined with relaxation exercises from the MBSRprogramme. In addition, there are group sessions where participants talk about possible behavioural changes to better cope with difficult everyday situations. 

This mindfulness-based therapy prevents a relapse in 40% to 50% of patients and is therefore just as effective as antidepressants – and without physical side effects. [5] [5] Psychology/Brain Research: Christian Wolf/www.spektrum.de (2015): Out of the Black Hole with Mindfulness Teasdale explains the success of his therapy bythat the diverse bouquet of mindfulness exercises has the right solution for every person and situation. [6] [6] Interview: PsychCentral (2018): How does mindfulness reduce Depression? Furthermore, mindfulness trains perception. When negative thoughts gather and announce a return of depression, Teasdale's therapy allows the warning signs to be recognised early enough to react accordingly.

Bridging the waiting time with mindfulness

In Germany, around 9,000 psychotherapists have a statutory health insurance license. They thus have capacity for about 1.5 million patients. However, more than 5 million people suffer from mental illnesses. [7] [7] Are there enough psychotherapists?: Wiebke Toebelmann/www.zeit.de (2011): "No Room for the Couch" The waiting time for a therapy place is on average 80 days. [8] [8] Psychologist shortage in Germany: Jens Lubbadeh/Spiegel Online (2012): "Therapist Desperately Sought" So that depression doesn’t become even more deeply rooted during this time, you can ask your health insurance about mindfulness training. [9] [9] Health courses: German Health Insurance/Euro-Informationen (2019): Health Insurance Support Prevention Many insurance companies cover up to 80 percent of the costs for stress prevention, yoga, or mindfulness courses. Even meditation apps are available. [10] [10] The health insurance pays: www.7mind.de (2019): Germany's most popular meditation app So you have plenty of options to start looking for a way out as quickly as possible and do not have to wait to be “saved”.

Depression and anxiety disorders often go hand in hand. How mindfulness can also help you with fears you can learn here.

“Side effects” of mindfulness

Not everything that glitters is gold, and so mindfulness doesn’t come without potential side effects either. Especially meditating can increase the tendency to brood. Although in theory it’s about accepting negative thoughts, in practice that is easier said than done. [11] [11] Meditation: Mechthild Klein/www.zeit.de (2018): "Enough with mindfulness"  What matters here: practise mindfulness when the forest doesn't look quite so threatening and dark and it's a little easier for you. Then it can serve you as a useful tool on the difficult days, with which you know how to cope. After all, you don't learn mouth-to-mouth resuscitation until the emergency has already occurred.

Conclusion

The various treatment options, the fear of medication treatment, or the worry of not getting a therapy place can cause a depression to grow into an even denser forest. We hope to be able to help you find a way out of the thicket with this article. In conclusion, we would also like to give you a positive thought to take with you:

If a mental illness like depression can have one good thing, it is that you are completely reset to zero and can find out anew: What actually does me good? – Armin Rösl, Press Spokesman of the Depression League.

If you or someone in your circle of acquaintances suffers from depressive symptoms, you will find help here:

Depression League

SeeleFon: 01805 950951

Email counseling: seelefon@psychiatrie.de

German Depression Aid Foundation

Info-phone: 0800 / 33 44 533

Regional offers: Map

Depression Discussion Forum

Exchange with sufferers: Online Forum

Pastoral Care

General pastoral care and suicide prevention: Email, chat, phone and on-site

Selfapy (paid)

Online courses and counseling

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This post is by Amelie Haupt. Thanks to her studies in business psychology, she is the “Psycho-Aunt” of the 6-Minuten-Verlag. Like her texts, her life is structured. She needs it too when she is out and about as a digital nomad again.

Sources:

[1, 2] How effective are antidepressants?: Institute for Quality and Efficiency in Health Care (IQWiG): Health Information

[3, 6] Interview: PsychCentral (2018): How does Mindfulness reduce Depression?

[4] Study: US National Library of Medicine National Institutes of Health (2017): Mindfulness-Based Interventions for Anxiety and Depression

[5] Psychology/Brain Research: Christian Wolf/www.spektrum.de (2015): Out of the Black Hole with Mindfulness

[7] Are there enough psychotherapists?: Wiebke Toebelmann/www.zeit.de (2011): "No Room for the Couch"

[8] Shortage of Psychologists in Germany: Jens Lubbadeh/Spiegel Online (2012): "Desperate Search for a Therapist"

[9] Health Courses: German Health Insurance Companies/Euro-Informationen (2019): Health Insurance Companies Support Prevention

[10] The Health Insurance Company Pays: www.7mind.de (2019): Germany's Most Popular Meditation App

[11] Meditation: Mechthild Klein/www.zeit.de (2018): "Enough with Mindfulness"