Topic Review: Mindfulness

75x increase in mentions of ‘mindfulness’ in newspapers since 2004.

14% percentage of people that practice meditation in the US.

9x increase in kids that meditate (US, 2012-2017).

66% percentage of Buddhists who meditate weekly.

45% percentage of Brits who think mindfulness can come with health benefits.

3/4 people who meditate who do it for wellbeing or health reasons.

29% percentage of people who meditate because they are anxious, nervous or worried.

 

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ORIGIN STORY

Exploring the impact of meditation: A timeless practice for modern mental wellbeing

The origins of meditation may go back as far as 3000 years. But it has now become more popular than ever. Yoga studios are on the rise and lots of gym classes include some flavour of mindfulness and meditation.

Due to COVID-19, anxiety and stress levels are through the roof, with some talking about a looming wave of mental health disorders. As a result many are trying to use mindfulness to alleviate their struggles, which would help flatten that other curve. The Dutch even have a term: “uitwaaien”. Strictly speaking, it refers to outdoor activities that replace ‘bad air’ for ‘good air’ to clear your mind and relieve stress. There is no science behind that principle, of course, although there is lots of evidence that exercise and time outdoors are both helpful against stress.

Here is a fun fact: the way we subjectively perceive time can be seen as a mirror of our internal state. Research has shown that people perceived that time was slowed down during lockdown earlier this year, for example. Here is where mindfulness kicks in, as it is all about focusing our attention in the present. In doing so, it not only changes our perception of the present moment but also our judgment of durations. The same researchers have indeed shown that time passes faster for those who meditate than for those who do not.

However, whether these activities can help our mental wellbeing is an entirely different question. Meditation has gained weight as a complement to traditional psychological interventions (like cognitive-behavioural therapy or CBT), much to initial skepticism from many. Plenty of research has been done during the last decade though, and it shows measurable effects. On the other hand, the jury is still out on just how large some of these effects are, and on whether or not you would get equivalent results in other ways.

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BACKGROUND

Does meditation trigger changes in the brain?

100% Affirmative via 8 experts

Read the full answers to this question here. If you want to convince a neuroscientist that meditation has any effects, first you need to show it can lead to physical changes in the brain. And our experts agree that it can. If done consistently over time, meditation can sculpt the brain and the connections between nerve cells, says Dr David Cregg, a psychology expert from Ohio State University.

For example, meditation can increase levels of a protein called brain-derived neurotrophic factor (BDNF), which is a key regulator of nerve cells. It can also change brain connectivity and a small study with older people also found it to improve some forms of memory.

By placing tiny electrodes around people’s head as they meditate, you can also see if their brain rhythms change. And again, they do. Recent data suggest that mindfulness training can also alter your brain’s firing patterns within a month, says Professor Yi-Yuan Tang, a cognitive scientist from Texas Tech University.

Crucially, these changes do not occur in random bits of the brain, but in a few hotspot areas. As reviewed by Prof Tang and others, these include regions that control attention (such as the anterior cingulate cortex or the striatum) and emotions (like the prefrontal cortex or the amygdala).

In a rare recent study led by Prof Shogo Kajimura from Kyoto Institute of Technology, they looked at a single volunteer for months as he practiced meditation to get a very detailed picture of his brain connections over time. They found that meditation can not only change connectivity within a certain brain region, but also reshuffle neuronal networks across the brain, explains Prof Kajimura.

But meditation does not just alter the function of the brain: it can affect its structure too. Brain imaging studies have detected anatomical changes resulting from meditation. Most studies have described an increase in volume of the affected regions, although others have found a shrinkage of these areas.

It is worth noting that none of these changes is a magical attribute of meditation. As several of our experts point out, the brain is an extremely plastic organ and will change in response to any activity we do routinely – be it meditation, chess or swing dance.

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THE CONSENSUS

Is there scientific evidence that mindfulness meditation improves mental health?

100% Affirmative via 9 experts

Read the full answers to this question here. The fact that mindfulness targets areas involved in emotion control brings us to the big question: does it really have knock-on effects on mental health?

According to psychologist Dr Rachael Heckenberg from La Trobe University, there is growing evidence (including a number of randomized clinical trials) that mindfulness-based interventions alleviate stress, depression and anxiety. Indeed, research has shown that meditation can help reduce distress and drop levels of the stress-hormone cortisol. Mindfulness-based interventions also help people suffering from depression and anxiety, although there is some controversy on the latter.

But not just that. Meditation can also be used to promote addiction recovery, says Prof Michael Posner from the University of Oregon. For example, just 5 hours of meditation over a fortnight halved smoking in a study done by his team. Mindfulness-based interventions have even been used in cases of eating disorders and to reduce high-risk behaviours such as violence or self-injury, as recently reviewed in Harvard Review of Psychiatry.

How about long-term gains? Studies disagree on how long benefits last if we stop practicing mindfulness, our experts say. According to Prof Tang, the duration of the effects will depend on how much we train. However, even a couple of months of practice could impact our behaviour for months or longer, he says.

It is important to stress that these data come from structured programmes led by qualified instructors, says Dr Alessio Matiz from the University of Udine. Improvements are typically measured using clinical outcomes (such as reduction in drug taking) or by self-reports where participants assess their perceived mental wellbeing, he explains. However, there are more reasons why interventions are carefully monitored. Meditation can also trigger psychologically unpleasant experiences, including the extreme case of potential backlash for trauma survivors. This is an often underlooked fact, and highlights why mindfulness training must be supervised by competent mental health professionals. Plus, the measured health benefits are by and large modest, and rarely warrant its use to replace standard interventions.

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HOW DOES MEDITATION AFFECT THE BRAIN

Brain regions affected by mindfulness meditation

 

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THE CONSENSUS

Can mindfulness meditation reduce pain?

56% Affirmative via 9 experts

Read the full answers to this question here. Chronic pain sufferers are also turning to mindfulness to try and alleviate their symptoms. Luckily, according to our experts, there is some data that mindfulness can indeed help reduce pain. But let us take a step back for a moment.

Pain is a complex phenomenon, and there are several dimensions to it. As explained by Dr Sara Lazar from Massachusetts General Hospital and Harvard Medical School, these include the physical sensation (intensity, location and duration of the pain, or how it feels) as well as the affective and cognitive responses (our perception of it).

Mindfulness seems most effective at tackling the latter, says Dr Lazar, which is why it can help people with chronic pain. Chronic pain is a condition where pain persists for months, even beyond the healing of the tissue damage — typically in muscles or areas like the back or neck. In these patients, pain sensations are worsened by thoughts and emotions like stress, anxiety or depression, which can exacerbate the suffering, explains Dr Lazar.

According to Prof Richard J. Davidson, psychiatry expert from the University of Wisconsin, mindfulness can alleviate such distress. Here, mindfulness is focused on getting the patients to intentionally observe their own feelings and sensations. This is called focused attention meditation. The aim is to uncouple the sensory component of pain and the cognitive and emotional components. Questions remain, Prof Davidson says, as to whether it reduces the actual pain. A 2017 review of the evidence concluded that adding meditation to the patients’ usual treatment only improves pain symptoms very slightly. However, this is not a placebo effect. In fact, mindfulness seems to act on multiple neurophysiological mechanisms, a recent review showed.

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Research has demonstrated that meditation can certainly help reduce stress (e.g., mindfulness-based stress reduction, or MBSR). However, whether it is the BEST is hard to say. There are a number of activities that can reduce stress, including exercise and planning enjoyable social activities. Meditation is just one of many healthy things one can use.

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TAKEAWAYS

• Mindfulness does not necessarily imply meditation, although it generally does. It covers a range of activities that intend to increase focus on the present.
• If you are serious enough, mindfulness will change your brain. The more you practice, the more it will. Specifically, it targets areas involved in controlling attention and regulating emotions.
• Mindfulness-based interventions can alleviate stress, depression and other conditions, including addiction and perhaps even pain. Remember that it is a complementary intervention and always check with health professionals first.
• Everyone is different, and mindfulness is one good choice in a range of options. You can also try getting more contact with nature, physical exercise and being more socially active (New Year’s Resolutions, here we come!)