Mindfulness as Effective as Medication in Preventing Relapse in Depression – Research

Mindfulness as Effective as Medication for Relapse

Mindfulness – the practice of attending to thoughts and feelings in the present moment – has been the focus of a lot of research attention recently and even under the full glare of science, it just keeps getting better.

In the first ever large scale study of its kind, researchers explored whether teaching people mindfulness would be as effective as maintenance doses of antidepressants in managing relapse in depression.

According to Willem Kuyken, lead author of the study and Professor of Clinical Psychology at the University of Oxford, without ongoing treatment four out of five people who struggle with depression will relapse.

Maintenance doses of antidepressant medication can reduce the risk of relapse by two-thirds, but it’s not without its problems. The side effects can be intolerable for some, and others might (understandably) be averse to an indefinite dependence on medication.


The Study: What They Did

424 adults with diagnosed major depression participated in the two year study. Half were required to stay on their antidepressant medication for the duration of the study. The other half slowly come off their medication and participated in mindfulness practice. People in this group attended eight weekly 2 ¼ hour group sessions consisting of guided mindfulness practices, group discussion and other cognitive behavioural exercises. They were also required to practice daily at home.

What They Found

At the end of two years, mindfulness was shown to be as effective as medication in preventing relapse, with the rates of relapse being 44% for the mindfulness group and 47% for the medication group.


The benefits of mindfulness therapy over medication include its low cost and its appeal to those who are reluctant to depend indefinitely on medication as a way to stave off depression.

The slide into depression can be triggered by negative thoughts and feelings about the self, others and the world. Mindfulness therapy aims to change the way people think and feel, teaching the skills to recognise and respond to thoughts and feelings that could otherwise set in motion a depressive downward spiral.

Through mindfulness, people can learn to appreciate that just because they think something, that doesn’t mean the thought is fact. Rather than hanging on to a thought and letting it gain momentum and strength, mindfulness teaches how to let the thought come and then go.

For more information on mindfulness, see MINDFULNESS: THE WHAT, THE HOW AND THE DIFFERENCE 5 MINUTES A DAY WILL MAKE

[Image Credit: Unsplash]

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Melbourne, Adelaide … Will you join us? 

The @resilientkidsconference is coming to Melbourne (15 July) and Adelaide (2 September), and we’d love you to join us.

We’ve had a phenomenal response to this conference. Parents and carers are telling us that they’re walking away feeling even more confident, with strategies and information they can use straight away. That’s what this conference is all about. 

We know taking care of the young people in our lives is up there with the most important thing we can do. Why shouldn’t there be a conference for parents and carers?!

I’ll be joining with @maggiedentauthor, @michellemitchell.author, and @drjustincoulson. We’ve got you covered! And we’re there for the day, with you. 

For tickets or more info, search ‘Resilient Kids Conference’ on Google, or go to this link https://www.resilientkidsconference.com.au/conference/.
We have to change the way we talk about anxiety. If we talk about it as a disorder, this is how it feels.

Yes anxiety can be so crushing, and yes it can intrude into every part of their everyday. But the more we talk about anxiety as a disorder, the more we drive ‘anxiety about the anxiety’. Even for big anxiety, there is nothing to be served in talking about it as a disorder. 

There is another option. We change the face of it - from an intruder or deficiency, to an ally. We change the story - from ‘There’s something wrong with me’ to, ‘I’m doing something hard.’ I’ve seen the difference this makes, over and over.

This doesn’t mean we ignore anxiety. Actually we do the opposite. We acknowledge it. We explain it for what it is: the healthy, powerful response of a magnificent brain that is doing exactly what brains are meant to do - protect us. This is why I wrote Hey Warrior.

What we focus on is what becomes powerful. If we focus on the anxiety, it will big itself up to unbearable.

What we need to do is focus on both sides - the anxiety and the brave. Anxiety, courage, strength - they all exist together. 

Anxiety isn’t the absence of brave, it’s the calling of brave. It’s there because you’re about to do something hard, brave, meaningful - not because there’s something wrong with you.

First, acknowledge the anxiety. Without this validation, anxiety will continue to do its job and prepare the body for fight or flight, and drive big feelings to recruit the safety of another human.

Then, we speak to the brave. We know it’s there, so we usher it into the light:

‘Yes I know this is big. It’s hard [being away from the people you love] isn’t it. And I know you can do this. We can do hard things can’t we.

You are one of the bravest, strongest people I know. Being brave feels scary and hard sometimes doesn’t it. It feels like brave isn’t there, but it’s always there. Always. And you know what else I know? It gets easier every time. I’ve know this because I’ve seen you do hard things, and because I’ve felt like this too, so many times. I know that you and me, even when we feel anxious, we can do brave. It’s always in you. I know that for certain.’♥️
Our job as parents isn’t to remove their distress around boundaries, but to give them the experiences to recognise they can handle boundaries - holding theirs and respecting the boundaries others. 

Every time we hold a boundary, we are giving our kids the precious opportunity to learn how to hold their own.

If we don’t have boundaries, the risk is that our children won’t either. We can talk all we want about the importance of boundaries, but if we don’t show them, how can they learn? Inadvertently, by avoiding boundary collisions with them, we are teaching them to avoid conflict at all costs. 

In practice, this might look like learning to put themselves, their needs, and their feelings away for the sake of peace. Alternatively, they might feel the need to control other people and situations even more. If they haven’t had the experience of surviving a collision of needs or wants, and feeling loved and accepted through that, conflicting needs will feel scary and intolerable.

Similarly, if we hold our boundaries too harshly and meet their boundary collisions with shame, yelling, punishment or harsh consequences, this is how we’re teaching them to respond to disagreement, or diverse needs and wants. We’re teaching them to yell, fight dirty, punish, or overbear those who disagree. 

They might also go the other way. If boundaries are associated with feeling shamed, lonely, ‘bad’, they might instead surrender boundaries and again put themselves away to preserve the relationship and the comfort of others. This is because any boundary they hold might feel too much, too cruel, or too rejecting, so ‘no boundary’ will be the safest option. 

If we want our children to hold their boundaries respectfully and kindly, and with strength, we will have to go first.

It’s easy to think there are only two options. Either:
- We focus on the boundary at the expense of the relationship and staying connected to them.
- We focus on the connection at the expense of the boundary. 

But there is a third option, and that is to do both - at the same time. We hold the boundary, while at the same time we attend to the relationship. We hold the boundary, but with warmth.♥️
Sometimes finding the right words is hard. When their words are angry and out of control, it’s because that’s how they feel. 

Eventually we want to grow them into people who can feel all their feelings and lasso them into words that won’t break people, but this will take time.

In the meantime, they’ll need us to model the words and hold the boundaries firmly and lovingly. This might sound like:

‘It’s okay to be angry, and it’s okay not to like my decision. It’s not okay to speak to me like that. I know you know that. My answer is still no.’

Then, when they’re back to calm, have the conversation: 

‘I wonder if sometimes when you say you don’t like me, what you really mean is that you don’t like what I’ve done. It’s okay to be angry at me. It’s okay to tell me you’re angry at me. It’s not okay to be disrespectful.

What’s important is that you don’t let what someone has done turn you into someone you’re not. You’re such a great kid. You’re fun, funny, kind, honest, respectful. I know you know that yelling mean things isn’t okay. What might be a better way to tell me that you’re angry, or annoyed at what I’ve said?’♥️
We humans feel safest when we know where the edges are. Without boundaries it can feel like walking along the edge of a mountain without guard rails.

Boundaries must come with two things - love and leadership. They shouldn’t feel hollow, and they don’t need to feel like brick walls. They can be held firmly and lovingly.

Boundaries without the ‘loving’ will feel shaming, lonely, harsh. Understandably children will want to shield from this. This ‘shielding’ looks like keeping their messes from us. We drive them into the secretive and the forbidden because we squander precious opportunities to guide them.

Harsh consequences don’t teach them to avoid bad decisions. They teach them to avoid us.

They need both: boundaries, held lovingly.

First, decide on the boundary. Boundaries aren’t about what we want them to do. We can’t control that. Boundaries are about what we’ll do when the rules are broken.

If the rule is, ‘Be respectful’ - they’re in charge of what they do, you’re in charge of the boundary.

Attend to boundaries AND relationship. ‘It’s okay to be angry at me. (Rel’ship) No, I won’t let you speak to me like that. (Boundary). I want to hear what you have to say. (R). I won’t listen while you’re speaking like that. (B). I’m  going to wait until you can speak in a way I can hear. I’m right here. (R).

If the ‘leadership’ part is hard, think about what boundaries meant for you when you were young. If they felt cruel or shaming, it’s understandable that that’s how boundaries feel for you now. You don’t have to do boundaries the way your parents did. Don’t get rid of the boundary. Add in a loving way to hold them.

If the ‘loving’ part is hard, and if their behaviour enrages you, what was it like for you when you had big feelings as a child? If nobody supported you through feelings or behaviour, it’s understandable that their big feelings and behaviour will drive anger in you.

Anger exists as a shield for other more vulnerable feelings. What might your anger be shielding - loneliness? Anxiety? Feeling unseen? See through the behaviour to the need or feeling behind it: This is a great kid who is struggling right now. Reject the behaviour, support the child.♥️

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