Business for you: Meditation As Medicine?

vendredi 28 février 2014

Meditation As Medicine?

For centuries, people have meditated to gain deeper insight and wisdom about themselves and their lives. More recently, researchers have studied meditation to gain insight about its effect on psychological wellbeing. Can it help ease pain, depression, or anxiety? Does it relieve stress, improve mood and concentration, or short-circuit substance abuse? What is its effect on sleep and weight?

To find out exactly what meditation can and cannot do, Madhav Goya, M.D., M.P.H, assistant professor of medicine in the division of general internal medicine at Johns Hopkins University in Baltimore, Maryland, conducted a review of the study literature to date. Dr. Goyal says he and his colleagues were looking for a consistent benefit that went above and beyond the placebo effect. To rate the studies, he says, “We asked, ‘How confident were we that what we saw was real?’” If the study was too small or the analysis was biased, Dr. Goyal and his colleagues were less confident that the results were reliable.

The Case for Meditation

After reviewing as many as 18,000 studies, Dr. Goyal said they found “small but consistent benefits for symptoms of anxiety, depression, and pain for mindfulness meditation.” And the effect was evident across a variety of populations, including people with fibromyalgia, depression, heart disease, and HIV. “No matter the population, we were pretty much seeing a similar signal. With anxiety, there was a 5 to 10 percent improvement. For depression, there was a 10 to 20 percent improvement, both of which are above and beyond placebo,” says Dr. Goyal.

It’s Easy To Learn

Even more surprising? Participants didn’t require months-long training in the techniques of mindfulness meditation to reap its benefits. “Self awareness and non-judgmentalness are difficult skills to acquire but subjects were learning them in a couple of hours over 8 weeks,” says Dr. Goval. “With minimal training, we were seeing these effects over multiple populations.”

Meditation’s Limitations — So Far

For symptoms other than pain, anxiety, and depression, Dr. Goyal and colleagues saw little or no effect of mindfulness or Transcendental Meditation on mood, attention, substance abuse, sleep or weight. That doesn’t necessarily mean it wouldn’t be effective, Dr. Goyal explains. “It could be the studies were very small, had higher risk of bias, or didn’t provide enough meditation training. If studies were done in a more rigorous manner, they might show that meditation has some effect.”

What Doctors Should Know

Either way, Dr. Goyal says, doctors should discuss meditation with their patients. “People can expect small to moderate improvements in anxiety, depression, and pain if they go through mindfulness meditation. It’s empowering and may reduce their dependence on other forms of care, such as pills. It’s something patients and clinicians should be aware of.”

Will Meditation Go Mainstream?

As evidence for meditation increases, doctors will prescribe it more frequently, predicts Dr. Goyal. “With more study and assuming that meditation has effects that are corroborated by trials, it will become formalized the way PT [physical therapy] is.” And eventually insurance may cover it. In the meantime, physicians can recommend mindfulness meditation for pain, anxiety, and depression, and educate patients about the practice. “Patients should understand that it’s a secular practice that requires some training and involves becoming aware of one’s thoughts, sensations, and breath,” he says. “These are basic things clinicians should be able to discuss.”

It doesn’t help that insurance doesn’t cover it. But clinicians can discuss the types of meditation. If they know places where it’s offered, they can recommend that. Many cancer centers have it. It may not be mainstream medicine yet, but it’s getting closer.

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