Feelings of overwhelming sadness and hopelessness are commonplace in people suffering from depression.
Antidepressant medications and psychotherapy help many people, but 50 to 80 percent of those who don’t get ongoing treatment will experience repeated bouts. Even patients on maintenance treatment, such as continuing antidepressants after improvement, are susceptible to relapse.
However, a June 2016 study suggests that a hybrid form of psychotherapy called mindfulness-based cognitive therapy (MBCT) is an effective way to lower the risk of recurrences-particularly for those individuals with severe depression.
How MBCT works
MBCT combines two widely studied approaches. The first approach, cognitive therapy, focuses on how your thoughts and beliefs influence your mood and behavior. The goal is to change negative thoughts that tend to trigger depression and replace them with positive, supportive thoughts.
The second approach, mindfulness, encourages you to focus your thoughts on the present moment, eliminating distracting or distressing feelings.
MBCT typically involves an eight-week program. Participants meet as a group and perform mindfulness meditation at home on their own. “Because many patients will suffer additional episodes of depression despite taking medication to prevent a relapse shows we need options,” says Peter Rabins, M.D., M.P.H., a professor at the Erickson School of Aging, University of Maryland, Baltimore County, and founding director of geriatric psychiatry at Johns Hopkins University School of Medicine in Baltimore. “The addition of MBCT to usual treatment lowers the risk of recurrence and can help end a cycle of repeated episodes.”
MBCT does not eliminate a patient’s need for antidepressants, but it appears that the combination of medication and psychotherapy is better than medication alone.
Putting MBCT to the test
To gauge the effectiveness of MBCT, researchers at Warneford Hospital at the University of Oxford in the United Kingdom reviewed evidence from nine European studies, which included 1,258 patients, mostly women, ages 39 to 56. Their results, published in JAMA Psychiatry, found that MBCT lowered the risk of a recurrence of depression by 31 percent compared to usual care for as long as 60 weeks after the initial therapy session. Patients with more severe depression were the most likely to benefit.
Like any psychotherapy, MBCT takes time and commitment. But, unlike medication, MBCT has no troublesome side effects. Still, researchers don’t know exactly why MBCT seems to help. In the study, the authors surmise one reason may be that MBCT patients are more aware of rising feelings of depression and then use their learned skills to ward off a relapse.
Another possibility is that people who focus on the present moment are less likely to ruminate about the past and future, while engagement in group sessions may help them realize they’re not alone in suffering from depression.
But psychotherapy may have farther-reaching effects: Previous research on mindfulness meditation has shown that it can alter brain function in areas involved in emotion and attention.