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Preventing Recurrence of Depression with Mindfulness-Based Cognitive Therapy

     

Depression is common, affecting an estimated one in 15 people in any given year. Women are more likely than men to experience depression. Some research shows one-third of women will experience a depression in their lifetime.

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Once a person has experienced a major depressive episode1, relapse is also common. Among people who have experience a major depressive episode, at least half are at risk for additional episodes. Among those who have experienced two depressive episodes, 80 percent are likely to experience another.

One approach increasingly being used to help address residual depression symptoms and to prevent relapse is mindfulness-based cognitive therapy (MBCT). MBCT combines components of cognitive behavior therapy and traditional mindfulness practices. Jon Kabat-Zinn, founder of the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School, describes mindfulness as "paying attention in a particular way, on purpose, in the present moment, without judgement."

An extensive body of research supports the use of mindfulness-based cognitive therapy to help prevent recurrence of depression in patients with residual depressive symptoms, or patients in remission and at risk for relapse. A recent review of research concluded that randomized controlled trials have provided evidence for mindfulness-based cognitive therapy equally as effective as maintenance antidepressant medication, leading to 30 to 34 percent lower risk of relapse.

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MBCT helps people with depression to quiet their repetitive upsetting thoughts and to detach from depression-related thoughts and feelings. It helps people to become more aware of the thoughts, feeling and sensations and to change the way they relate to these thoughts.2 It also provides education about depressive illness and cognitive patterns.

MBCT typically involves eight weekly group sessions along with daily home assignments. It is also available as a live online program (for example through the UMass Medical School Center for Mindfulness). It teaches formal meditations (such as body scan and sitting meditations) and informal mindfulness practices (such as mindfulness of everyday activities). Session topics include such things as dealing with barriers, staying present, thoughts are not facts, and using what’s been learned to deal with future moods.

Antidepressant medications are effective for many people in treating depression and preventing relapse, but not for everyone, and they can have unwanted side-effects. Some people prefer nonmedication approaches. MBCT offers an alternative. Even for people with a preference for medication, MBCT can be useful. One study found that those with a preference for medication did equally as well with MBCT as those with a preference for mindfulness.

Researchers Zendel Segal, Ph.D. and Kathleen Walsh suggest that the benefits of mindfulness-based cognitive therapy result from mindfulness meditation skills that support emotion regulation and are easily incorporated into daily routines.

Resources

References

  1. A major depressive episode is a period of at least 2 weeks when a person experiences a depressed mood or sadness most days, great loss of interest or pleasure in activities once enjoyed and at least three other symptoms (such as changes in appetite, sleeping too little or too much, loss of energy, feeling worthless or guilty, trouble focusing, feeling restless or agitated). The symptoms cause extreme distress or problems in social or work function.
  2. MacKenzie, M.B. and Kocovski, N. Mindfulness-based cognitive therapy for depression: trends and development. Psychology Research and Behavior Management, 2016, (9):125-132. www.ncbi.nlm.nih.gov/pubmed/27274325

     

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