MINDFULNESS MAY ASSIST IN THE TREATMENT OF MIGRAINE

A recent study, published in the JAMA Internal Medicine, of mindfulness-based stress reduction (MBSR) has found that MBSR can assist in the treatment of migraine.

Migraine is a neurological condition that can cause multiple symptoms. It is frequently characterized by intense, debilitating headaches. Symptoms may include nausea, vomiting, difficulty speaking, numbness or tingling, and sensitivity to light and sound. The condition of migraine often runs in families and can affect all ages.

Photo credit: MedicineNet. All rights reserved.

MBSR is an eight-week program that offers secular, intensive mindfulness training to assist people with stress, anxiety, depression and pain. Thereafter, participants are encouraged to practise mindfulness on a daily basis. For what it's worth, here is my definition--description might be a better word--of mindfulness:

Mindfulness is the watchful, receptive and purposeful presence of bare attention to, and choiceless awareness of, the content of the action—both internal and external—of the present moment ... from one moment to the next.

 

The outcomes of this recent study indicate that while MBSR does not appear to reduce the frequency of migraines, pain perception and other secondary outcomes including quality of life did improve.

Migraine is the second leading cause of disability around the world. Unfortunately, about two-thirds of migraine sufferers discontinue migraine medications for various reasons. In recent years there has been a growing interest in non-pharmacological approaches to the treatment of the condition.

 

‘For a condition with recurrent, lifelong unexpected attacks,’ the study authors wrote, ‘improving a patient’s pain perception and ability to function despite migraine has significant implications for overall long-term emotional and social health.’

Reference

Wells R E, O’Connell N, Pierce C R, et al. ‘Effectiveness of mindfulness meditation vs headache education for adults with migraine: A randomized clinical trial.’ JAMA Intern Med. Published online Dec 14, 2020. doi:10.1001/jamainternmed.2020.7090

MINDFULNESS AND RESPONSES TO EMOTIONAL STIMULI

How well can you control your emotions?

The essence of mindfulness is acceptance and non-reactivity. It’s like the old-fashioned tape recorder or the modern-day video surveillance camera; the equipment records but does not react to what it hears or sees. So it is with mindfulness.

Ordinarily, whenever there is an activating experience, there follows an emotional response on our part. The emotional response may be positive, negative or neutral. In between the activating experience and the emotional response is the interpolation of some belief or misbelief (eg ‘This is pleasant’, ‘This is unpleasant’, and so on) about the activating experience which causes us to pass judgment on, and then react emotionally to, the experience.

A recent study, involving more than 150 adults, evaluated the impact of long and short-term mindfulness meditation training on the amygdala response to emotional pictures in a healthy, non-clinical population of adults using blood-oxygen level dependent functional magnetic resonance imaging.

Now, the amygdala, at the end of the hippocampus, is part of the limbic system of our brain and is responsible for the processing of memory, decision-making and emotional responses, especially fear, anxiety and aggression. Mindfulness meditation and other forms of meditation can quieten the activity of the amygdala.

 Photo credit: National Institute of Mental Health.

Long-term meditators had 9081 hours of lifetime practice on average, primarily in mindfulness meditation. Short-term training consisted of an eight-week mindfulness-based stress reduction (MBSR) course. The control group, made up of people with no meditation experience, was randomly assigned to a ‘health enhancement program’ over the same time period that included well-being practices, but not meditation specifically.

After an eight-week period, participants viewed and labelled photos as either emotionally positive, negative or neutral while undergoing a brain scan by functional magnetic resonance imaging.

Meditation training was associated with less amygdala reactivity to positive pictures relative to controls, but there were no group differences in response to negative pictures. Reductions in reactivity to negative stimuli may require more practice experience or concentrated practice, as hours of retreat practice in long-term meditators was associated with lower amygdala reactivity to negative pictures, although the researchers did not see this relationship for practice time with MBSR.

Short-term training, compared to the control intervention, also led to increased functional connectivity between the amygdala and a region implicated in emotion regulation (in particular, the processing of risk and fear), namely, the ventromedial prefrontal cortex (VMPFC), during affective pictures. Thus, meditation training may improve affective responding through reduced amygdala reactivity, and heightened amygdala–VMPFC connectivity during affective stimuli may reflect a potential mechanism by which MBSR exerts salutary effects on emotion regulation ability.

Study: Krak T R A et al. ‘Impact of short- and long-term mindfulness meditation training on amygdala reactivity to emotional stimuli.’ NeuroImage vol 181, 1 November 2018, 301-313.

MINDFULNESS TRAINING IMPROVES YOUR BRAIN

A new systematic review has looked at all studies published prior to July this year that investigated brain changes associated with 8 weeks of mindfulness-based stress reduction or mindfulness-based cognitive therapy.

The combined results suggest that a short course of secular mindfulness training leads to multiple brain changes similar in nature to those seen in people who have practised religious or spiritual meditation for a lifetime.

Rinske Gotink [pictured left] and her colleagues found 30 relevant studies that used MRI or fMRI brain imaging to look at the effects of mindfulness training on brain structure and function, including 13 randomly controlled trials.

Associated brain changes, in terms of activity levels and volume and connectivity changes, have been reported in the prefrontal cortex (a region associated with conscious decision making and emotional regulation and other functions), the insula cortex (which represents internal body states among other things), the cingulate cortex (decision making), the hippocampus (memory) and the amygdala (emotion).

Based on what we know about the function of these brain regions, Gotink’s team said these changes appear to be consistent with the idea that mindfulness helps your brain regulate your emotions.

Study: Gotink, R A et al. ‘8-week Mindfulness Based Stress Reduction induces brain changes similar to traditional long-term meditation practice – A systematic review.’ Brain and Cognition. Vol 108, Oct 2016, pp 32-41. Available online 16 Jul 2016.

Acknowledgments. This post is based on material appearing on the Readers Digest blog of the British Psychological Society.

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IMPORTANT NOTICE: See the Terms of Use and Disclaimer. The information provided on this blog is not a substitute for professional medical advice, diagnosis or treatment. Never delay or disregard seeking professional medical advice from your medical practitioner or other qualified health provider because of something you have read on this blog. In Australia, for immediate advice or support call Lifeline on 13 1 1 14, beyondblue on 1300 22 4636, or Kids Helpline on 1800 55 1800, and for information, advice and referral on mental illness contact the SANE Helpline on 1800 18 SANE (7263) or go online via sane.org. In other countries, call the relevant mental health care emergency hotline or simply dial your emergency assistance telephone number and ask for help.

MINDFULNESS CAN REDUCE FEAR AND FATIGUE FOR CANCER SURVIVORS

Mindfulness in the form of mindfulness-based stress reduction (MBSR), a tailored six-week mindfulness program, can lead to improvements in some physical and psychological symptoms that breast cancer survivors often experience, according to a new study published in the Journal of Clinical Oncology.

‘Although not all patients suffer to a high degree from these distressing symptoms, research shows that due to treatment and long-term effects often patients experience depression, anxiety, sleep disturbances, fears of recurrence (FORs) and physical symptoms of pain and fatigue,’ said lead author Professor Cecile A Lengacher [pictured below] of the University of South Florida College of Nursing in Tampa, Florida.

When breast cancer survivors transition off of treatment and experience physical symptoms, they may worry that it’s a sign of cancer recurrence and be at a higher risk for anxiety and depression, Dr Lengacher told Reuters Health by email.

The researchers tested the effects of a MBSR program and examined whether any particular types of patient seemed to benefit most from the therapy. For the study, researchers compared 155 breast cancer survivors who completed a six-week MBSR program with 167 survivors who received usual care. Symptoms of depression, anxiety and stress, fear of cancer recurrence, fatigue, pain and quality of life were all measured before the study began, after the six-week program ended and another six weeks later.

Women in the mindfulness program attended two-hour sessions conducted by a clinical psychologist once weekly and received training manuals and CDs. They practiced four meditation techniques, including sitting, walking, body scan and Hatha yoga and learned how to apply them in daily life.

The researchers kept track of how many sessions each participant attended and how much of the assigned 15 to 45 minutes of at-home practice per day each completed, based on their diaries.

For the MBSR group, the largest mindfulness-related improvements happened during the first six weeks and most were maintained at 12 weeks. They experienced a greater reduction in anxiety, fear of recurrence and fatigue compared to those in the control group, although the improvements were small to moderate.

There was no meaningful difference for depression scores or pain levels, according to the results.

Mindfulness practice helps patients learn how to self-regulate their emotions by acceptance and non-reacting to internal and external cues and experiences, reducing reactions to emotional and physical triggers, and learning to be in the present, which diminishes the distress of worrying about the past or future, Dr Lengacher said.

‘Also, this trial showed that those patients with the most stress had the highest benefit from this trial, indicating the importance of screening patients for distress,’ Dr Lengacher said.

Survivors of other types of cancer also suffer from varying symptoms depending on type and stage of cancer, she said.

Study: Lengacher, C A et al. ‘Examination of Broad Symptom Improvement Resulting From Mindfulness-Based Stress Reduction in Breast Cancer Survivors: A Randomized Controlled Trial.’ Journal of Clinical Oncology. Published online before print May 31, 2016, doi:10.1200/JCO.2015.65.7874JCO May 31, 2016 JCO657874.

Acknowledgment: Reuters Health. Doyle, K. ‘Mindfulness program may reduce fear, fatigue for cancer survivors.’ Life | Thu Jun 2, 2016 2:57pm EDT. All rights reserved.

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IMPORTANT NOTICE: See the Terms of Use and Disclaimer. The information provided on this blog is not a substitute for professional medical advice, diagnosis or treatment. Never delay or disregard seeking professional medical advice from your medical practitioner or other qualified health provider because of something you have read on this blog. In Australia, for immediate advice or support, call Lifeline on 13 1 1 14, beyondblue on 1300 22 4636, or Kids Helpline on 1800 55 1800, and for information, advice and referral on mental illness contact the SANE Helpline on 1800 18 SANE (7263) or go online via sane.org. In other countries, call the relevant mental health care emergency hotline or simply dial your emergency assistance telephone number and ask for help.

HAVE YOU TRIED MINDFULNESS FOR YOUR BACK PAIN?

To date, mindfulness-based stress reduction (MBSR) has not been rigorously evaluated for young and middle-aged adults with chronic low back pain. 

A recent issue of the Journal of the American Medical Association reports on a trial which compared treatment with MBSR with usual care as well as cognitive behavioural therapy (CBT).

In a study of 342 adults aged 20-70, randomly and equally allocated to each treatment group and having suffered with back pain for an average of 7.3 years, those given mindfulness training found it easier to get out of chairs, go upstairs and had less pain than those given usual care.

In the MBSR group, 61 per cent felt more able to move around without pain than the 44 per cent who carried on with their usual care. CBT was equally as good as MBSR at reducing pain. The effects lasted for at least a year.

Among adults with chronic low back pain, treatment with MBSR or CBT, compared with usual care, resulted in greater improvement in back pain and functional limitations at 26 weeks, with no significant differences in outcomes between MBSR and CBT. 

These findings suggest that MBSR may be an effective treatment option for patients with chronic low back pain.

Study: Cherkin, Daniel C et al. ‘Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial.’ JAMA. 2016;315(12):1240-1249. doi:10.1001/jama.2016.2323.

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IMPORTANT NOTICE: See the Terms of Use and Disclaimer. The information provided on this blog is not a substitute for professional medical advice, diagnosis or treatment. Never delay or disregard seeking professional medical advice from your medical practitioner or other qualified health provider because of something you have read on this blog. In Australia, for immediate advice or support call Lifeline on 13 1 1 14, beyondblue on 1300 22 4636, or Kids Helpline on 1800 55 1800, and for information, advice and referral on mental illness contact the SANE Helpline on 1800 18 SANE (7263) or go online via sane.org. In other countries, call the relevant mental health care emergency hotline or simply dial your emergency assistance telephone number and ask for help.

NEW STUDY FINDS MINDFULNESS HELPS LOW-INCOME MINORITY YOUTHS

A school-based mindfulness program led to improved psychological functioning and lower levels of post-traumatic stress symptoms in low-income, minority youths, according to a recent randomized, controlled study.

The study analysed the effect of mindfulness instruction in fifth- through eighth-graders at two Baltimore City Public Schools. More than 99 per cent were both African-American and eligible for free lunch.

Researchers randomly assigned students to receive mindfulness-based stress reduction (MBSR) instruction adapted from an adult program or general education on health topics (HT). Self-report survey data collected at baseline and post-program from 300 students were analysed in the report.

At baseline, the two groups had similar scores on measures of psychological functioning, mindfulness and trauma symptoms. At the end of the 12-week program, MBSR students reported significantly lower levels of depressive symptoms, somatization, negative affect, negative coping, rumination, self-hostility and post-traumatic symptom severity than HT students.

Study: Sibinga E M S, Webb L, Ghazarian S R, and Ellen J M. ‘School-based mindfulness instruction: an RCT.’ Pediatrics. December 18, 2015.

Addenda.

Here are two recent news items from Australia on the subject of mindfulness and school children:

1. Mindfulness relaxation undertaken by a Canberra ACT school has seen overwhelming benefits for its young students, teachers say. Thomas Neilson, from the University of Canberra, says schools nationwide need to look at implementing similar models to defuse rising stress levels in their students.

2. Following the successful Canberra trial, Clarence Valley NSW mindfulness coach John Shearer wants the NSW State Government to introduce mindfulness into the school curriculum.

IEJ. 10 January 2016.

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MINDFULNESS AND INFLAMMATORY BOWEL DISEASE

A recent study published in the journal Inflammatory Bowel Diseases suggests that training in meditation and other mindfulness-based techniques can bring lasting improvements in mental health and quality of life for patients with inflammatory bowel disease (IBD). IBD, of which Crohn's disease and ulcerative colitis are the principal types, is a complex disease involving chronic inflammation of some or all of the digestive tract.

‘Our study provides support for the feasibility, acceptability, and effectiveness of a tailored mindfulness-based group intervention for patients with IBD,’ concludes the research report by Clinical Professor Dr David Castle [pictured left], Chair of Psychiatry at St Vincent's Hospital, Melbourne, Australia, and colleagues. However, more research is needed to demonstrate the clinical benefits of mindfulness techniques, including whether they can help to reduce IBD symptoms and relapses.

The researchers evaluated a mindfulness-based stress reduction (MBSR) program tailored for patients with IBD. The study included 60 adults with IBD: Crohn's disease or ulcerative colitis. The patients' average age was 36 years, and average duration of IBD 11 years. Twenty-four patients had active disease at the time of the study.

The MBSR intervention consisted of the usual 8 weekly group sessions plus a daylong intensive session, led by an experienced instructor. The program included guided meditations, exercises designed to enhance mindfulness in daily life, and group discussions of challenges and experiences. Participants were also encouraged to perform daily ‘mindfulness meditation’ at home.

Thirty-three patients agreed to participate in the MBSR intervention, 27 of whom completed the program. Ratings of mental health, quality of life, and mindfulness were compared to those of the 27 patients who chose not to participate (mainly because of travel time).

Source: Medicine.Net.com

Anxiety, depression, and decreased quality of life are common in patients with IBD. Psychological distress may lead to increased IBD symptoms and play a role in triggering disease flare-ups. The study revealed that the MBSR participants had greater reductions in anxiety and depression scores, as well as improvement in physical and psychological quality of life. They also had higher scores on a questionnaire measuring various aspects of mindfulness--for example, awareness of inner and outer experiences. Six months later, MBSR participants still had significant reduction in depression and improvement in quality of life, with a trend toward reduced anxiety. The patients were highly satisfied with the mindfulness intervention.

Dr Castle and colleagues conclude, ‘A larger adequately powered, randomised study with an active control arm is warranted to evaluate the effectiveness of a mindfulness group program for patients with IBD in a definitive manner.’

Study: Neilson K, Ftanou M, Monshat K, Salzberg M, Bell S, Kamm MA, Connell W, Knowles SR, Sevar K, Mancuso SG, and Castle D. ‘A Controlled Study of a Group Mindfulness Intervention for Individuals Living With Inflammatory Bowel Disease’ (doi: 10.1097/MIB.0000000000000629).

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IMPORTANT NOTICE: Please read the Terms of Use and Disclaimer. The information provided on or linked to this blog is not a substitute for professional medical advice, diagnosis or treatment. Never delay or disregard seeking professional medical advice from your medical practitioner or other qualified health provider because of something you have read on this blog or elsewhere. For immediate advice or support call (in Australia) Lifeline on 13 1 1 14 or Kids Helpline on 1800 55 1800. For information, advice and referral on mental illness contact (in Australia) the SANE Helpline on 1800 18 SANE (7263) go online via sane.org. In other countries call the relevant mental health care emergency hotline or simply dial your emergency assistance telephone number and ask for help.