Research evaluates the effects of meditation training on patients’ biological reaction to stress
Characterized by persistent and excessive worry, generalized anxiety disorder affects nearly seven million adults in the U.S
Those who are prone to anxiety tend to have greater difficulty managing and coping with stress, experts say, where chronic stress is shown to have physiologic effects including raising heart rate and blood pressure and increasing one's risk for heart attack and stroke. In an effort to find calm, research shows those struggling with anxiety may be well-served by turning to mindfulness meditation – a technique that involves focusing on the present and non-judgmentally paying attention to thoughts and feelings as they arise.
“If you think of anxiety – there are anxious thoughts and there are anxious feelings, and those go together,” says Judson Brewer, director of research for the Center for Mindfulness at the University of Massachusetts Medical School. “There are two ways that we can deal with them.”
One is our natural learned response that since anxiety feels bad, he says, we need to do something to make it feel better. “So we avoid it, we suppress it, we repress it – we do all these things to distract ourselves from the anxiety itself.” However, attempts to avoid uncomfortable thoughts and feelings may worsen anxiety. “The paradox here is that mindfulness helps us turn toward those and learn to change our relationship to the actual thoughts and the physical sensations, rather than try to change them in any way,” Brewer says. “By changing that relationship, we actually stop feeding those cyclical processes and they start to die off on their own.” By learning mindfulness-based stress reduction – an approach first developed at UMass that uses meditation to lower stress levels – research finds many people report reduced anxiety and stress levels.
Taking that a step further, a recent National Institutes of Health-funded study published in January in the journal Psychiatry Research also looked at the biological responses of patients with generalized anxiety disorder to stress, after they’d undergone MBSR. In the study, 70 participants were randomly assigned either to receive the mindfulness meditation training or to undergo stress management education – the study’s control group. “This was a sort of a wellness class where there was a series of lectures on different topics, like sleep improvement and exercise and nutrition,” says Dr. Elizabeth Hoge, an associate professor of psychiatry at Georgetown University Medical Center in Washington. Hoge conducted the research while she was a postdoctoral researcher at Massachusetts General Hospital.
Participants were asked to give an impromptu speech in front of an audience of testers – a typically stress-inducing experience – before and after the 8-week intervention, either the mindfulness meditation training or the stress management class. They were also asked to do mental arithmetic: “Start with the number 996 and subtract by seven all the way down to zero, which is really hard to do in front of an audience,” Hoge notes. “The testers had all the numbers in front of them on a clipboard and they were wearing white lab coats, and we videotaped and had microphones and photography flood lamps. [We] basically set up the laboratory stress test to be like the worst kind of speech challenge that a person can experience.”
Even so, blood testing revealed that study participants had significantly lower levels of the stress hormone ACTH and inflammatory reactions to stress (measured by looking at inflammatory proteins IL-6 and TNF-α) following mindfulness meditation training. That compared to the control group for whom biological stress responses actually increased somewhat the second time they underwent the social stress test.
The results offer biological data showing how mindfulness meditation training can affect the ability of a person with generalized anxiety disorder to be resilient in the face of stressful circumstances. “You can’t fake that,” Hoge says; nor could the results be explained by the placebo effect or a patient’s expectation that meditation would help, since their reactions were measured at a physiological level. “For people who have generalized anxiety disorder, our research provides evidence that this might be a reasonable treatment option,” she says.
Hoge says one of the reasons she was interested in pursuing the research was to look at alternatives to standard treatments for anxiety disorders, typically antidepressant medication and psychotherapy. “It’s hard for some people to get those treatments, either because of insurance, financial limitations and also the stigma that’s involved with coming to a psychiatric clinic for treatment," she says. "And a lot of people don’t want to go on medications.”
Though standard treatments work well for many patients, experts say it’s important to provide various options to match individual preference.
One question that remains is whether the stress levels – measured on a biological level – would be reduced over the long term by meditative techniques, says Dr. Madhav Goyal, an internist at NorthBay Healthcare in Vacaville, California, and an assistant professor of general internal medicine at Johns Hopkins University School of Medicine in Baltimore. Goyal has done research on meditation programs to address stress and improve well-being. “We know that people who are more stressed in general tend to be more susceptible to getting infections” among other health issues, Goyal says.
If meditation can treat anxiety disorder and help those with anxiety better cope with stress, it could also improve a person’s overall health in the long term. But more research is needed to determine the impact that meditation might have on chronic stress levels, Goyal says.
In the immediate term, for individuals considering meditation to treat anxiety disorder, Brewer suggests MBSR, which has been well-studied in this regard. The Center for Mindfulness has a worldwide online directory of MBSR teachers certified by the UMass Center for
Mindfulness.
Ultimately, experts say, meditation may help those with anxiety gain a greater understanding of more troubling underlying emotions, such as sadness or anger, while improving their ability to cope with stress. “Instead of being drawn into these long worry bouts, people can have more freedom to deal with those thoughts in a way that’s more constructive,” Hoge says.
Writer: Michael O. Schroeder / Health.news.com
