February 25, 2021, 3:59 Feb

Does mindfulness reduce anxiety?

I thought I'd start things off with something light. I've recently got into meditating once or twice a day, mainly in the hope of daydreaming less, being more focussed and being less stressed. Mindfulness and meditation (I must admit I don't bother to differentiate between the two) seems sensible - it can't hurt, and I know rational people who do it. It was recommended at my department at Imperial for example, and I have a couple of extremely chill friends who practice it. This isn't the obvious silly stuff, like quantum reiki energy, or even the less obviously probably useless intervention like CBD oil. But does it help?

Some people make extraordinary claims about meditation - supposedly the Dalai Lama said that "‘f every eight-year-old in the world is taught meditation, the world will be without violence within one generation" (see here). In the same article, it is claimed that some people believe that mindfulness will give them telepathic powers and the like. To be clear, I would be happy with much less - a moderate decrease in reported stress and anxiety for example. Or a slight increase in reported happiness. Set the bar low, and you have less chance of being disappointed, though I must admit telepathy would be very cool.

Confident with the tools and techniques I've learnt from Ben Goldacre himself (reading his books, not from personal acquaintance), I searched the Cochrane Library to see what came up there and was faced with lots of reviews of very specific interventions. Without wanting to be too callours, I don't care too much about whether mindfulness helps reduce stress in breast cancer patients. I'd be happy to know that it does, but I'm more interested to know if this applies to the population at large.

So I searched "systematic review mindfulness meditation" on Google (I don't trust DuckDuckGo with these things), and was pleasantly surprised to find quite a few hits. I'm a busy person, so I decided to just read the abstracts and conclusions. Let's start with Effects of Brief Mindfulness-Based Interventions on Health-Related Outcomes: a Systematic Review. They claim that even short interventions (5 mins) can have positive health related impacts, of wich they say most studies considered focussed on"anxiety and depression, as well as emotion regulation, stress, and cognitive outcomes." Good news! Another review found "Meditation interventions had an effect on compassion and empathy, but not on aggression, connectedness or prejudice." They did also mention that "compassion levels only increased under two conditions: when the teacher in the meditation intervention was a co-author in the published study; and when the study employed a passive (waiting list) control group but not an active one.". Hmmm...

Coming back to Cochrane, one paper, Evidence-based mindfulness summarised the 9 reviews found when searching their library. They found that the "Cochrane reviews showed a lack of conclusive evidence for fibromyalgia, aggressiveness in intellectually disabled people, anxiety disorders, somatoform disorders and post-stroke fatigue" and concluded that "there is a general lack of evidence mindfulness as an effective treatment.". Finally, a meta analysis on "Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis" found the following:

After reviewing 17,801 citations, we included 47 trials with 3,320 participants. Mindfulness meditation programs had moderate evidence to improve anxiety [ ES 0.38 (CI 0.12 to 0.64) at 8 weeks; ES 0.22 (0.02 to 0.43) at 3–6 months], depression [ES 0.30 (0.00 to 0.59) at 8 weeks; ES 0.23 (0.05 to 0.42) at 3–6 months] and pain [ES 0.33 (0.03 to 0.62)], and low evidence to improve stress/distress and mental health-related quality of life. We found either low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (drugs, exercise, other behavioral therapies).

When skimming over these, I initially concluded that mindfulness / meditation was useless (or of only a very limited benefit). Having written this down though, I would say that this is perhaps too harsh - there do seem to be some moderate benefits to reducing anxiety for example, which highlights to me the importance of writing things down. I also noticed that I confused two concepts: mindfulness / meditation and systematic reviews and meta analyses. I'm not bothered to correct this here, but again I'm happy to see that writing this down made this confusion obvious.

Will I change my behaviour then? I will definitely try to continue meditating / being mindful, but I won't rave about it to anyone either. Not that I was doing much of that anyway. Who needs mindfulness when you have Drum & Bass?

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