Mindfulness is an integrative, mind-body based approach that helps people to manage their thoughts and feelings. It is becoming widely used in a range of contexts. It is recommended by NICE as a preventative practice for people with experience of recurrent depression.
Mindfulness exercises are ways of paying attention to the present moment, using techniques like meditation, breathing, and yoga. Training helps people to become more aware of their thoughts, feelings, and body sensations so that instead of being overwhelmed by them, they’re better able to manage them. Practising mindfulness can give more insight into emotions, boost attention and concentration, and improve relationships.
Mindfulness can be practiced by children, young people and adults. There are different ways to practice mindfulness. Group courses run to practise mindfulness in person and there are online courses too where you can learn through self-directed practice at home. You don’t need to be religious or spiritual to practise mindfulness – it can help people with or without religious beliefs.
Mindfulness and mental health
Mindfulness is recommended as a treatment for people with mental ill-health as well as those who want to improve their mental health and wellbeing.
There are also different sorts of mindfulness meditation which can help people in different ways. Evidence shows compelling support for Mindfulness Based Stress Reduction (MBSR), which helps people to cope with stress, and for Mindfulness Based Cognitive Therapy (MBCT), which is designed to help people with recurring depression. They provide a flexible set of skills to manage mental health and support wellbeing.
The evidence for mindfulness
Mindfulness meditation has been shown to affect how the brain works and even its structure. People undertaking mindfulness training have shown increased activity in the area of the brain associated with positive emotion – the pre-frontal cortex – which is generally less active in people who are depressed.
More than 100 studies have shown changes in brain wave activity during meditation and researchers have found that areas of the brain linked to emotional regulation are larger in people who have meditated regularly for five years. The evidence for different types of mindfulness is promising and research has grown in recent years.
Mindfulness-Based Cognitive Therapy
Mindfulness-Based Cognitive Therapy is recommended by the National Institute for Health and Care Excellence for the prevention of relapse in recurrent depression. It combines mindfulness techniques like meditation, breathing exercises and stretching with elements from cognitive behaviour therapy to help break the negative thought patterns that are characteristic of recurrent depression.
Evidence shows that Mindfulness-Based Cognitive Therapy can, on average, reduce the risk of relapse for people who experience recurrent depression by 43%. Research also suggests that it’s particularly effective for vulnerable groups who are more likely to relapse (J Williams et al, “Mindfulness-Based Cognitive Therapy for Preventing Relapse in Recurrent Depression: A Randomized Dismantling Trial”, 2013.). As a psycho-social approach to staying well, it’s a cost-effective and accessible treatment for individuals and providers (M Williams and W Kuyken, “Mindfulness-based cognitive therapy: a promising new approach to preventing depressive relapse”, 2012).
Right now, very few people are referred onto Mindfulness-Based Cognitive Therapy. Our 2010 survey found that 69% of GPs said they rarely or never refer their patients with recurrent depression for Mindfulness-Based Cognitive Therapy.
Similarly, 75% of GPs have prescribed anti-depressant medication to patients with recurrent depression believing that an alternative might be more appropriate. Availability of the therapy around the country as a National Health Service treatment is still limited and there is ongoing work to explore how widely available this is in 2014 (Jo Rycroft-Malone et al, “Accessibility and implementation in UK services of an effective depression relapse prevention programme – mindfulness-based cognitive therapy (MCBT): ASPIRE study protocol, 2014).
It’s clear that work still needs to be done to increase the availability of mindfulness as an effective intervention.
Mindfulness-Based Stress Reduction (MBSR)
Mindfulness-Based Stress Reduction aims to address prolonged periods of stress which can lead to poor mental and physical health.
Mindfulness-Based Stress Reduction can be helpful as a single treatment to manage stress in individuals who do not experience mental ill health, as well as a joint intervention with other treatments for people who have symptoms of anxiety (W R Marchand, “Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and Zen Meditation for Depression, Anxiety, Pain, and Psychological Distress”, 2012).
The approach incorporates different techniques including meditation, gentle yoga and mind-body exercise. It’s been developed and studied since the 1970s for its impact on mental health and a 58% reduction in anxiety levels and 40% reduction in stress.
Research into individuals with “problematic” levels of stress found significant improvement in perceived levels of stress over the course. The findings of this research were consistent with other studies showing that changes in mindfulness “precede changes in perceived stress” (RA Baer et al, “Weekly change in mindfulness and perceived stress in a mindfulness-based stress reduction program”, 2012).
Who can benefit?
Mindfulness can be useful for people from all different walks of life and the number of areas that mindfulness is being applied to is growing.
Mindfulness has proven to be effective for children and young people, with school-based interventions having positive outcomes on wellbeing, reducing anxiety and distress as well as improving behaviour, among other areas (K Weare “Developing mindfulness with children and young people: a review of the evidence and policy context”, 2013). Evidence also suggests that children who used mindfulness practices more frequently reported higher wellbeing and lower stress scores (W Kuyken et al, “Effectiveness of the Mindfulness in Schools Programme: non-randomised controlled feasibility study”, 2013).
A successful Mindfulness in Schools project was set up in 2007 and is now being taught in 12 different countries. This nine-week course is especially designed for school students, whether they be dealing with exam stress, bullying, or seeking to enhance study skills. It's being used to improve students’ wellbeing as well as helping them to learn and concentrate better.
Mindfulness practice within criminal justice settings is currently being developed around the country. In HMP Brixton a “Mind/Body workout group” was established to help individuals to develop their own mindfulness practice. Evidence on the effectiveness of mindfulness interventions in prisons has been gathered mainly in the USA; a study based in Massachusetts found significant improvements in hostility, self-esteem, and mood disturbance following a course of mindfulness (M Samuelson et al, “Mindfulness-Based Stress Reduction in Massachusetts Correctional Facilities”, 2007).
A limited amount of research into mindfulness during pregnancy has shown encouraging results on the positive impact of mindfulness, finding ‘significantly’ reduced anxiety (C Vieten, “Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study”, 2007).
We are currently supporting research at the University of Oxford on the impact of mindfulness practice in pregnancy.
Mindfulness in the workplace has been popularised by a number of global companies including Google. However among smaller businesses mindfulness is not yet widespread.
There is growing evidence, shown by initial studies, that mindfulness in the workplace can have a number of positive effects. These include a decrease in perceived stress, and an increase in better concentration levels including memory tasks and multi-tasking. Research in 2012 found that mindfulness in the workplace could be an effective intervention to target ”high stress levels, sleep quality, and autonomic balance” (RQ Wolever et al, “Effective and viable mind-body stress reduction in the workplace: a randomized control trial”, 2012 “).
For even more information about how to get started with mindfulness or to take an online course, visit Be Mindful.