New treatment hope for people with recurring depression

[Guest guest]

New treatment hope for people with recurring depression

Study finds mindfulness-based cognitive therapy as effective as anti-depressant medication

Research

shows for the first time that a group-based psychological treatment,

Mindfulness Based Cognitive Therapy (MBCT), could be a viable

alternative to prescription drugs for people suffering from long-term

depression.

In a study, published today (1 December 2008) in the Journal of Consulting and Clinical Psychology,

MBCT proved as effective as maintenance anti-depressants in preventing

a relapse and more effective in enhancing peoples' quality of life. The

study also showed MBCT to be as cost-effective as prescription drugs in

helping people with a history of depression stay well in the

longer-term.

Funded by the Medical Research Council (MRC), the

study was led by Professor Willem Kuyken at the Mood Disorders Centre,

University of Exeter, in collaboration with colleagues at the Centre

for Economics of Mental Health (CEMH) at the Institute of Psychiatry,

King's College London, Peninsula Medical School, Devon Primary Care

Trust and the Medical Research Council Cognition and Brain Sciences

Unit.

The randomised control trial involved 123 people from

urban and rural locations who had suffered repeat depressions and were

referred to the trial by their GPs. The participants were split

randomly into two groups. Half continued their on-going anti-depressant

drug treatment and the rest participated in an MBCT course and were

given the option of coming off anti-depressants.

Over the 15

months after the trial, 47% of the group following the MBCT course

experienced a relapse compared with 60% of those continuing their

normal treatment, including anti-depressant drugs. In addition, the

group on the MBCT programme reported a higher quality of life, in terms

of their overall enjoyment of daily living and physical well-being.

Members

of the study team from the Institute of Psychiatry, King's College

London also compared the cost of providing MBCT programmes with the

cost of maintenance anti-depressant treatment. The findings suggest

that MBCT provides a cost-effective alternative to anti-depressant

drugs. Unlike most other psychological therapies, MBCT can be taught in

groups by a single therapist, and patients then continue to practice

the skills they have learned at home by themselves. Therefore, MBCT is

less costly than individual treatments and is not dependent on having

the large number of trained therapists needed for one-to-one

psychological treatments so could help the National Health Service

shorten its waiting lists for psychological therapies.

During

the eight-week trial, groups of between eight and fifteen people met

with one therapist. They learned a range of meditation exercises that

they could continue to practice on their own once the course ended.

Many of the exercises were based on Buddhist meditation techniques and

helped the individual take time to focus on the present, rather than

dwelling on past events, or planning for future tasks. The exercises

worked in a different way for each person, but many reported greater

acceptance of, and more control over, negative thoughts and feelings.

Professor

Willem Kuyken of the University of Exeter said: "Anti-depressants are

widely used by people who suffer from depression and that's because

they tend to work. But, while they're very effective in helping reduce

the symptoms of depression, when people come off them they are

particularly vulnerable to relapse. MBCT takes a different approach –

it teaches people skills for life. What we have shown is that when

people work at it, these skills for life help keep people well."

Professor

Kuyken continues: "Our results suggest MBCT may be a viable alternative

for some of the 3.5 million people in the UK known to be suffering from

this debilitating condition. People who suffer depression have long

asked for psychological approaches to help them recover in the

long-term and MBCT is a very promising approach. I think we have the

basis for offering patients and GPs an alternative to long-term

anti-depressant medication. We are planning to conduct a larger trial

to put these results to the test and to examine how MBCT works."

MBCT

was developed by a team of psychologists from Toronto (Zindel Segal),

Oxford (Mark ) and Cambridge ( Teasdale) in 2002 to help

people who suffer repeated bouts of depression. It focuses on targeting

negative thinking and aims to help people who are very vulnerable to

recurring depression stop depressed moods from spiralling out of

control into a full episode of depression. MBCT is becoming more widely

available as part of psychological treatment services in the NHS.

Case studies

Case study 1: Di

Di

Cowan of Sampford Peverell, East Devon, has suffered from depression

since he was in his late teens, though it was not diagnosed until much

later. Now 53, he has been taking anti-depressant drugs for more than

15 years and has had no previous psychological treatment.

It

is now two years since he completed the eight-week MBCT trial and Di

practices the meditation techniques learned during the trial four or

five times a week, for up to an hour each time. He plans to continue

doing this for the rest of his life.

Di explains how the

techniques learned on the trial have helped him in his daily life:

"It's helped me immensely. It's given me the ability to come up against

something that would have previously thrown me, think it through, come

up with a solution and then move on. It's helped me deal with recurrent

thoughts."

Shortly after completing the trial, Di was

diagnosed with bone cancer and had to undergo treatment, including a

major spinal operation, which has left him less mobile than he was

before. Despite this set-back, he feels he is managing his depression

using the techniques learned on the MBCT trial.

He says: "My

view of the world has changed and I look at life in a new light. I'm

much more cheerful and positive. Other people noticed a change. My

friends and family were very quick to comment that I was showing an

improvement."

Di concludes: "It was very worthwhile and I

would highly recommend it to anyone who has similar problems. It's a

very sound way of combating mental illness and promoting mental health."

Originally

from Manchester, Di has lived in Devon for 28 years. He is a retired

Maths teacher and is married with two boys, aged 19 and 11.

Case study 2:

hopes that MBCT will be "the final piece in the jig-saw" in learning to

cope with a tendency towards severe depression that he has suffered

since his teens. Now 56, he experienced severe episodes between 2000

and 2002, involving hospitalisation. Having already tried a number of

alternative therapies, and talking cures, as well as anti-depressant

drugs, he finally agreed to try the mood-stabiliser, Lithium

Soon

afterwards, he embarked on a course of cognitive behavioural therapy,

and it was via this route that he heard of MBCT. "It was the right

thing at the right time", he says. Sufficiently "stabilised" by

Lithium, he was able to benefit fully from the techniques taught, which

he now practices on a daily basis, some six years later.

The

group context of MBCT was important for him. Not only did participants

share their individual experiences of depression, and find common

ground in symptoms suffered and warning signs to heed, they also helped

keep each other "on track" with the practical homework involved.

believes that, in addition to the group's support,

self-discipline helped him complete the eight week course and has been

essential for him to continue regular practice at home. He says:

"Persistence and determination are necessary during the course and

become even more vital when you're on your own."

, who

lives in Exeter, is realistic enough to suspect that, without Lithium

he could not have reaped the benefits of MBCT. However, he says:

"Mindfulness gave me added insight into the way I function and respond

to people, and helped me become more accepting. Along the way I have

gained an understanding that, much of the time, life may not be as I

would like it, but an awareness – particularly a body awareness – of

such situations can lead to easier acceptance of them, and sometimes to

beneficial change. Maybe, one day, I'll have gained sufficient insight

not to need the Lithium any more".

###

Canada Toolbar : Search from anywhere on the web and bookmark your favourite sites. Download it now!