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Antidepressant Alternatives | Mindfulness-Based Cognitive Therapy for Depression Relapse

Is There a Cure for Depression

“Weight gain, sexual dysfunction, fatigue, the zaps – I’m tired of the antidepressant merry-go-round. Come on now, there have to be alternatives. Am I at least sort-of right?”

Rather than relying on the continuing use of antidepressants mindfulness puts me in charge, allowing me to take control of my own future, to spot when I am at risk and to make the changes I need to stay well.

Actually, you’re more than sort-of right. Not that antidepressant alternatives are going to be front page news. Big Pharma will see to that (did I really say that?).

Hey, I have no problem with antidepressants (ADs). Heck, I’ve used tricyclics and SSRIs along my anxiety and mood recovery journey. They have their place.

But I’ve come to know there are alternatives and augmenters that work every bit as good, if not better than ADs for depression and anxiety woes. And here’s yet another application…

Antidepressants vs. Mindfulness-Based Cognitive Therapy

Let’s consider the results of the very first large study to compare mindfulness-based cognitive therapy (MBCT) with maintenance ADs for the prevention of depression relapse.

So the results tell us MBCT isn’t superior to maintenance ADs. However, along with the results of previous trials, the study suggests MBCT may offer similar relapse protection for those who’ve endured multiple depressive episodes. And, by the way, at no significant difference in cost.

Shoot, that’s an attention-grabber, if you ask me.

This from Dr. Willem Kuyken, lead study author and Professor of Clinical Psychology at the University of Oxford (U.K.)…

Depression is a recurrent disorder. Without ongoing treatment, as many as four out of five people with depression relapse at some point.

And co-author Professor Richard Byng, from the Plymouth University Peninsula Schools of Medicine and Dentistry (U.K.), follows in kind…

Currently, maintenance antidepressant medication is the key treatment for preventing relapse, reducing the likelihood of relapse or recurrence by up to two-thirds when taken correctly. However, there are many people who, for a number of different reasons, are unable to keep on a course of medication for depression. Moreover, many people do not wish to remain on medication for indefinite periods, or cannot tolerate its side effects.

So why was MBCT chosen as the alternative for the study? Well, it was developed to help people who have experienced repeated bouts of depression by teaching them the skills to recognize and constructively respond to the thoughts and feelings associated with relapse.

And that prevents the downward spiral into depression.

The Guts of the Study

The work was done at the University of Exeter (UK). 424 adults taking maintenance ADs for recurrent major depression were recruited from primary care practices.

Half of the participants were randomly assigned to come off their AD slowly and receive MBCT. The other half continued their medication.

The MBCT folk attended eight 2 ¼ hour group sessions and were given daily home practice. After group, they had the option of attending four follow up sessions over a 12 month period. The work consisted of guided mindfulness practices, group discussion, and other cognitive-behavioral exercises.

The AD individuals continued their meds for two years.

All participants were assessed at regular intervals over two years for major depressive episodes.

The Take-Away

Over the two years, relapse rates in both groups were similar – right at 45%.

According to co-author Professor Sarah Byford, from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London…

As a group intervention, mindfulness-based cognitive therapy was relatively low cost compared to therapies provided on an individual basis and, in terms of the cost of all health and social care services used by participants during the study, we found no significant difference between the two treatments.

Dr. Kuyken believes the study brings forth a wonderful new choice for the millions of people with recurrent depression on repeat prescriptions.

So much for the gals and guys with all the letters after their name. What about the participants? Here’s an important comment…

Mindfulness gives me a set of skills which I use to keep well in the long term. Rather than relying on the continuing use of antidepressants mindfulness puts me in charge, allowing me to take control of my own future, to spot when I am at risk and to make the changes I need to stay well.

Might you one day express the same?

Let’s Close

No doubt about it, there are antidepressant alternatives. You have choices. Best part is, they work.

If you’re managing depression relapse, please consider mindfulness-based cognitive therapy. For information directly from the source, check-out the site.

Imagine chatting with your psychiatrist or primary care physician about long-term depression management, and s/he offers antidepressants and MBCT as equal options.

In a perfect world…

Credit due to sciencedaily.com for the study scoop. They cite The Lancet.

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  • Patricia Miller

    I’m wondering what happens if you use BOTH the medication and the mindfulness practices? Could you do better than that 46% relapse number over the two year period? It would be my goal to shoot for some better numbers in my life so mixing the best of all practices might end up working for me. Just thinking out loud here.

    • Your point is well-taken, Patricia. I think the study authors were doing the either/or thing because there was a focus on cost of services. Okay, so meds and participating in MBCT – with a therapist – equates to two expenses. However, if one can afford it – why not? ‘Course, one could use meds and do mindfulness work on their own.

      I think you’re spot-on. Appreciate the insight…

      • You can meditate and take medication. Did it for years.

  • i will read more on this. i feel great off antidepressants but my psych wants me on toprimate; i am terrified to add one more drug. http://beyondmeds.com/2015/07/18/befriending-fear/

    • Chipur readers – Nancy is referring to topiramate (Topamax), an anticonvulsant https://en.wikipedia.org/wiki/Topiramate

      • and topiramite is addictive though not sppossed to be too hard to get off. i distust; i am bipolar among other things, this doc asking me to detox alcohol, gabapentin and klonopin at the same time. i suspect he thinks topiramate will help mood when it is shown to be ineffective. patients love that it causes weight loss; as i have already lost many pounds on a ketogenic, i don’t need this except for mood stabilazation as i am freaking out over possible eviction by slumlords .like all detoxing patients, i am very angry. i am facing eviction. this does not feel like the time to get radically sober. i am pissed. and i have been an impeccible tenant for 12 years…yes, very pissed.

        btw mindfulnes is now contiversial. we with major disorders simply learn to dissaciote. but i am glad for my zen community though not one cared about my suicide attempt. yes, i am detoxing and i am pissed at evryone.

        sorry for the misspellings. and the rant.

        bill, thanks for mentioning beyond meds.

      • Heck, Nancy – you can rant with lousy spelling anytime here…