/ 24 January 2014

Meditation takes on medication

At peace: Buddhist nun Mila Kelsang says that even five minutes of meditation a day can reduce stress levels.
At peace: Buddhist nun Mila Kelsang says that even five minutes of meditation a day can reduce stress levels.

Are you feeling anxious or depressed? Wait a minute before you pop the Prozac. Meditation, a cheaper and safer option, could be all the medicine you need. 

New research from Johns Hopkins University in the United States suggests that daily meditation can reduce the symptoms of depression and anxiety by up to 20%. 

"The improvement we saw in depressive symptoms was similar to what other studies have found using antidepressants," said study leader Madhav Goyal. 

The study showed that the traditionally Buddhist practice of "mindfulness meditation" resulted in a 5% to 10% improvement in symptoms of anxiety and a 10% to 20% improvement in symptoms of depression.

The research in the form of a meta-analysis (the use of statistical methods to combine results of previously published studies), was published in the peer-reviewed journal of the American Medical Association, the Journal of Internal Medicine, on January 6, and the researchers focused on 47 clinical trials involving 3515 participants who had a medical or psychiatric condition.  

"But most of the patients [involved in the report] had mild symptoms and did not have full-blown anxiety or major depression," Goyal said.

The results of the typically eight-week-long meditation programmes also suggested the practice could alleviate some pain symptoms. 

According to Goyal, mindfulness meditation is a form of "self-awareness of the mind and body that focuses nonjudgmental attention on the moment at hand".

"Different mindfulness practices may focus on different aspects of self-awareness, such as awareness of the breath, thoughts, bodily sensations or a combination of these."

"I'm so stressed. I need to meditate"
Lauren Richards, a Johannesburg-based attorney, has been practising this kind of meditation for almost three years to cope with severe anxiety.

"I'm not a calm person," she said. "And I've tried pretty much everything including a lot of different types of medication."

Richards, who attends meditation classes at the Vajrapani Kadampa Buddhist Centre in Craighall Park, said she "reacted badly" to many of the prescribed antidepressants.

But, since she started meditating, she has been able to reduce the dosage of her medication considerably.

"If you think 'I'm so stressed. I need to meditate' it's much better than 'I'm so stressed. Where are my pills?'" she laughed.

Goyal said that scientists don't know how the meditation "works" to alleviate these psychological symptoms but they have a theory: "It could be that mindfulness programmes teach individuals to reduce the way they react to negative emotions and symptoms."

This echoes Richards's own experience with the practice: "You learn that you can't change what's happening around you but you can change the way you perceive it and the way you choose to deal with it."

Even five minutes is beneficial
Goyal suggests one meditates for half an hour a day as this is the time most mindfulness programmes, in the analysed trials, prescribed.

But Mila Kelsang, a Buddhist nun who was born in South Africa, said that as little as five minutes a day would be beneficial to the psyche. 

"We want to dress beautifully on the outside but what's important is to dress our mind with patience. So if we were to just spend five minutes focusing on our breathing and learning to relax every morning before leaving the house we have a better chance of not getting angry or stressed during the day."

When she was ordained in 2010 in the New Kadampa Tradition of Buddhism, which combines Tibetan tradition with the idea of adaptation to make the religion more relevant to Western communities, she received the name Mila Kelsang. In line with the tradition, she is celibate, her head is shaven, she wears the traditional maroon and yellow robes every day and has chosen to "dedicate [her] life in the service of others".

Kelsang, who also heads up the Kadampa Buddhist Centre in Craighall Park, said that meditation is beneficial for those who suffer from mental illness because it is a "retraining of what to do with our thoughts when they start to spiral".

It helps with anxiety specifically because it relaxes the mind. 

"Meditation gives us a brief reprieve from that constant state of flux or tension we get in an anxious mind."

Doctors should be aware
Goyal said that, although meditation is not considered part of mainstream medical therapy, clinicians should be aware of this evidence when prescribing treatments to their patients, particularly if a patient's symptoms are mild. 

"While there may be benefits for those with more severe symptoms, and three trials did look at such patients, we are not making any statements about that group due to a lack of enough data," he said.

But, Goyal said, these trials provided relatively small "doses" of meditation training – typically 30 minutes a day.

"We don't know if more meditation practise would result in larger benefits and this needs to be tested in future research. What's also important is that there is no known major harm caused by meditation and it doesn't come with any known side effects. One can also practise meditation along with other treatments one is already receiving."

Richards looks at meditation as a "good dependency".

"You can meditate for the rest of your life but, if you can help it, you don't want to be on medication for the rest of your life."


The battle between breath and thoughts

"Be aware of your thoughts but don't hold on to them," says Mila Kelsang, a Buddhist nun from the Vajrapani Kadampa Buddhist centre in Craighall Park, Johannesburg.

I am sitting in a quiet room in the Sandton library, one of the venues in which she teaches, participating in a guided mindfulness meditation class. "Slowly start becoming aware of your breath," she says, in her soft, low voice, which seems to flow steadily from her mouth like water – enhancing the tranquil atmosphere in the room.

My eyes are closed and my body is relaxed as I try to steer my mind away from the thousands of thoughts racing through it. I manage to focus on the sensation of air going into my nostrils and out again – but only for a moment – then I think: "I should have turned off my phone."

It's almost as if she reads my mind as she says: "If your thoughts stray, notice them, let them go and then bring your attention back to your breath."

The rest of the 15-minute meditation consists of repeating this battle between my focus on the present, on my breathing, and all the other thoughts that intermittently sneak into my consciousness. Focusing on only the sensation of inhaling and exhaling is taxing mental work but it is also surprisingly relaxing.

As I open my eyes I feel calmer but I also wonder whether my struggle to focus undermined any of the expected mental benefits. 

Mila tells me focus will improve with time and practise but each meditation session, no matter how unfocused one feels, is beneficial.

And I begin to believe her: as I board the Gautrain back to Rosebank my mind and body remain uncharacteristically relaxed and I feel much more prepared to face the day.