Can anxiety disorders be treated without medication? While many effective treatments for anxiety disorders are known, many patients find it difficult to utilize them. This may be due to lack of knowledge or limited availability of structured methods providing these treatments. Especially in certain regions or countries, medication often ends up as the only option for patients.
Past reports have often suggested the effectiveness of mindfulness-based programs for depression and anxiety. But do these programs really work for treating anxiety disorders? According to a study published in JAMA Psychiatry in Nov 2022, the answer is yes. This study compared the effectiveness of Escitalopram, a leading medication for anxiety disorders, and a Mindfulness-Based Stress Reduction Program (MBSR). Given that the comparison was performed through a blinded randomized trial, the outcomes are quite credible.
The study spanned eight weeks. For the medication part, Escitalopram was used with dosages ranging from 10-20mg, adjusted according to symptoms and progress. For the mindfulness program, the MBSR program was applied. MBSR included eight mindfulness sessions of 2.5 hours each, held once a week over eight weeks. After each session, participants performed daily mindfulness exercises at home for 45 minutes. Retreats dedicated to mindfulness were also provided on the weekends of the 5th and 6th weeks. Each session explained the theories and methods of mindfulness meditation, guided by a mindfulness expert.
The study included a total of 208 participants; 106 underwent medication treatment while 102 participated in the mindfulness meditation. The results showed that mindfulness meditation demonstrated equivalent effectiveness to medication treatment. During the process, 78.6% of those using medication therapy experienced side effects- such as insomnia, sleep interference, nausea, fatigue, headache, drowsiness, sexual dysfunction, nightmares, appetite loss, nervousness, dizziness, anxiety. Meanwhile, 15.4% of those who practiced mindfulness meditation reported side effects, all indicating an increase in anxiety.
Given the results, mindfulness seems to have equivalent therapeutic effects with fewer side effects, thus appearing to be a more favorable method. However, it is not as simple as it seems; as evidenced above, mindfulness meditation sessions demand more time and energy. Still, it is undeniably an effective method when executed correctly. So, why is mindfulness meditation effective in reducing anxiety? Mindfulness meditation allows us to “perceive thought as just a psychological event,” enabling emotional regulation and making people less impacted by thoughts and emotions.
This principle is shared among various non-pharmacological treatments, including cognitive-behavioral therapy. For those using medication therapy but needing additional non-pharmacological interventions, it may be helpful to use other well-designed programs that suit them, not limited to mindfulness meditation.
