It is important to recognize that our health of mind and body is essentially one, with many common physiological pathways for conditions that we still label as mental or physical, despite so often being present together. However, given the current health service structures for delivering services, this briefing paper looks at mental and physical health in turn.
Around the world, too many suffering from poor mental health do not seek or receive treatment. In fact, according to the Adult Psychiatric Morbidity Survey (APMS), 6 in 10 adults in the UK with conditions such as anxiety or depression do not receive treatment. Similar stats apply around the world. While there has been an increase, this was mainly driven by a steep rise in the use of medication, with prescriptions for antidepressants almost doubling in the last decade. So many who require support do not access treatment. . In addition, a significant proportion of people prescribed antidepressants do not take them as recommended, for reasons including side effects or concerns, for example, in women planning pregnancy.
Depression is often a long-term and recurrent disorder. Unlike CBT and antidepressants, MBCT has been specifically developed to help people not only deal with current symptoms but also to reduce the risk of them recurring in the future. The American Psychological Association has recently conducted an overview of MBCT for depression and concluded the evidence was strong.
Mindfulness-Based Cognitive Therapy (MBCT) is unique amongst interventions for depression in that it has wide, mainstream appeal and is non stigmatizing. One reason for this is that it is popular amongst healthy individuals wishing to flourish, as well as those who are really struggling with depressive episodes.
Due to the increasing success of mindfulness apps like RethinkCare many patients will already have given mindfulness practice a try in some form, making them more open to taking an evidence-based structured course. Mindfulness-Based Interventions (MBIs) like MBCT are consistently found to be ‘highly acceptable’ to participants in research looking at a wide range of contexts from clinical health applications to schools and workplaces. Health, Wellbeing & Mindfulness.
A recent systematic review of the impact of mindfulness-based interventions for mental illnesses showed:
- The clearest evidence was for mindfulness for depression. The impact of mindfulness-based interventions was similar to current NHS first line therapies such as cognitive behavioural therapy and antidepressants and better than other therapies.
- For anxiety, mindfulness impact was similar to other evidence-based therapies.
- For smoking, mindfulness outperformed evidence-based therapies.
- For pain and weight/eating, mindfulness performed on par with other active therapies.
- The most consistent evidence was seen for depression, pain, smoking, and addictions.
- The most extensive body of research shows the impact of MBCT and MBSR on depression, anxiety, stress and burnout. There is increasing use of MBCT to treat Post Traumatic Stress Disorder in, for example, U.S. combat veterans with significant results. Mindfulness-based practice is also being used in mental health services focused on ADHD, dementia, eating disorders, OCD, schizophrenia, suicidal thinking. Recent studies from the U.S. and the Netherlands have also shown a significant impact in preventing postnatal depression.
Physical Health and Mindfulness
Our knowledge, motivation, attitude and resources (inner and external) influence how poor mental health affects the quality of our lives and how we manage a health condition. Mindfulness affects many physiological aspects of health and also the mental framing of our response to health. Both are relevant to supporting health and wellbeing.
A meta-analysis found that mindfulness training enhances coping with distress and disability in everyday life, as well as under more unusual conditions of serious disorder or stress. At a time when widespread chronic pain has led to an opioid epidemic in the U.S., the value of mindfulness-based pain management programs to significantly reduce the experience of pain has considerable potential.
Many qualities and traits strengthened by mindfulness are significant for health self-management:
- Compassion & self-compassion – vital for preventing, recovering or reducing depression, suicidal thoughts and for health & care workers
- Observing the transience of thoughts – reduces stress-induced rumination, sleeplessness, emotional reactivity, anxiety, suicidal thoughts
- Responding to difficulty with ‘breathing space’ practices – reduces rumination, sleeplessness, emotional reactivity, anxiety, blood pressure, panic attacks
- Sense of wider connection – helps cope with loss, life events, diagnoses, trauma, loneliness
- Being in the present moment – reduces fear of the future or anger & regret for the past
- Attention regulation and reduction in reactivity – ‘witnessing’ emotional responses and addictive patterns of behavior e.g. eating disorders, self-harm, smoking, gambling, violence, managing pain or fears
- Stronger mind-body connection – awareness of the body, how we treat it and its changes
Medical specialists in many different conditions are using mindfulness with their patients to enable them to participate in improving their mental and emotional wellbeing and managing their condition. The research evidence base is growing rapidly. Perhaps because mindfulness addresses the foundations of wellbeing, conditions where mindfulness-based treatments or training is being used are wide-ranging, including: Addictions, Cancer, Cardiovascular Disease & Blood Pressure, Dementia & Memory Loss, Diabetes, Epilepsy, Fatigue, Fibromyalgia, HIV/AIDS, Autism and Learning Disability, Huntington’s Disease, IBS, Menopause, Multiple Sclerosis, Obesity, Pain management, Parkinson’s Disease, Psoriasis, Rheumatoid Arthritis, Sleep, and Tinnitus.
About the Author: This excerpt was edited and reprinted with the permission of our friends at The Mindfulness Initiative. To learn more about their work, please visit www.themindfulnessinitiative.org.
Find the original work here.