Imagine you could cure depression with a therapy that was more effective and long-lasting than expensive drugs, and which did not have any side effects. These are the claims being made for a form of Buddhist meditation.
Last week, psychologists from the University of Exeter published a study into "mindfulness-based cognitive therapy" (MBCT), finding it to be better than drugs or counselling for depression. Four months after starting, three quarters of the patients felt well enough to stop taking antidepressants.
MBCT marries Eastern meditation with Western cognitive therapy. Patients are taught the simple technique over eight sessions and then practise it at home for 30 minutes a day. Professor Willem Kuyken, whose team at the Mood Disorders Centre of the University of Exeter carried out the research, says: "Anti-depressants are widely used by people who suffer from depression and that's because they tend to work. While they're very effective in helping reduce the symptoms of depression, when people come off them they are particularly vulnerable to relapse. For many people, MBCT seems to prevent that relapse. It could be an alternative to long-term antidepressant medication."
MBCT was developed in the mid-Nineties by psychologists at the universities of Oxford, Cambridge and Toronto to help stabilise patients' moods during and after use of antidepressants. About half of patients relapse into depression – even if they continue taking the medication. One common reason for a relapse is when a normal period of sadness turns into obsessive brooding.
"Brooding is a key feature of depression," says Mark Williams, professor of clinical psychology at the University of Oxford and leader of the team that developed MBCT. "In mentally healthy people, sad thoughts pass quite quickly but in people who suffer from depression they don't. MBCT tackles brooding and teaches people to be more compassionate to themselves and others."
The MBCT technique is simple, and revolves around ''mindfulness meditation''. In this, you sit with your eyes closed and focus on your breathing. (See box for details). Concentrating on the rhythm of the breath helps produce a feeling of detachment. The idea is that you come to realise that thoughts come and go of their own accord, and that your conscious self is distinct from your thoughts. This realisation is encouraged by gentle question-and-answer sessions modelled on those in cognitive therapy.
In the University of Exeter study, funded by the Medical Research Council, 47 per cent of patients with long-term depression suffered a relapse; the figure was 60 per cent among those taking medication alone. Other studies, including two published in the Journal of Consulting and Clinical Psychology, had comparable outcomes. As a result, the National Institute for Health and Clinical Excellence has recommended MBCT since 2004. But NHS availability is still patchy. Many sufferers seek private treatment, with courses at Buddhist centres costing around £120.
"One of the key features of depression is that it hijacks your attention," says Prof Williams. "We all tend to bring to the forefront of our minds the thoughts and feelings that reflect our current mood. If you are sad, depressed or anxious, then you tend to remember the bad things that have happened to you and not the good. This drives you into a downward spiral that leads from sadness into a deeper depression. MBCT prevents and breaks that spiral."
1. Sit upright in a straight-backed chair, with your spine about an inch from the back of the chair, and your feet flat on the floor.
2. Close your eyes. Use your mind to watch your breath as it flows in and out. Observe your sensations without judgement. Do not try to alter your breathing.
3. After a while your mind will wander. Gently bring your attention back to your breath. The act of realising that your mind has wandered – and bringing your attention back – is the key thing.
4. Your mind will eventually become calm.
5. Repeat every day for 20–30 minutes.