The first-ever study to compare medication and meditation for anxiety found that both methods are equally effective in reducing symptoms.
This finding was published in JAMA Psychiatry on Wednesday. It suggests that people suffering from anxiety can be helped by either a daily pill (which may have side effects) or a daily mindfulness practice (which requires a significant time commitment).
“For both treatments, we had people who said that it worked,” said Dr. Elizabeth Hoge (director of the Anxiety Disorders Research Program, associate professor of psychiatry at Georgetown University Medical Center, Washington, D.C.).
According to the Anxiety & Depression Association of America, 6.8 million Americans have a generalized anxiety disorder. However, less than half of them receive treatment.
276 patients with generalized anxiety disorder were included in the two-month study. One-half of the patients were treated with escitalopram (brand: Lexapro), while the other half received a common antidepressant. The other half was taught mindfulness-based stress reduction techniques.
Both groups experienced moderate improvements, with a 20% decrease in symptoms after the study.
This kind of benefit is consistent in other studies of medication to treat anxiety, according to Craig Sawchuk, a psychologist at Mayo Clinic in Rochester (Minnesota), who was not involved in the new research.
“The study shows that there are other options that don’t involve medication to treat anxiety and that they are just as effective,” Lindsey McKernan (associate professor of psychiatry, behavioral sciences, Vanderbilt University Medical Center, Nashville, Tennessee), said. She was not part of the study.
People who took the antidepressant had more side effects than those who didn’t. Nearly 80% experienced some sort of side effects such as difficulty sleeping, nausea, and increased anxiety. The majority of side effects were mild.
One side effect, an increase in anxiety, was reported by approximately 15% of participants in the mindfulness group.
However, the mindfulness program was very time-consuming. Participants had to attend two weekly, 2 1/2-hour, group classes for eight weeks and one day of a retreat. They were also instructed to meditate for 45 minutes every day throughout the study period.
Hoge observed that 58% of Lexapro users were still using the drug at six months, while only 28% of those in the meditation group were still practicing mindfulness at a minimum of four days per week.
She said that it was not clear why meditation participants seemed to stop participating. They could have been experiencing no symptoms or the time constraints made it impossible to continue.
Sawchuk stated that it might be easier to remember to take medication only once per day than to fit in a 45-minute meditation.
Hoge stated that mindfulness was essential for the participants to be able to practice the right techniques. Mindfulness is a way to focus on one thing at a time, such as breathing or listening to the sounds around you. It also helps with clearing your mind of all other thoughts.
It’s hard to keep your mind focused on this for more than a few moments before you start to think about other things, such as to-do lists, what-ifs, and concerns about the future. Mindfulness helps the brain to not be so distracted by these distracting thoughts.
Hoge explained that mindfulness can help reduce anxiety. Hoge gave the example of someone worried about failing an exam. She said, “Before treatment that thought makes them sweaty, nervous and they can’t focus on anything else.” “But the problem is not the thought, but the reality of it.”
Hoge stated that accepting such thoughts and moving on “creates freedom.” The thought may arise, but it does not have to control the person.
McKernan stated, “It’s almost like helping you create a system that allows you to learn how to react to stress rather than react to it.”