Popcorn Thoughts + Treating Depression with Mindfulness Based Cognitive Therapy (MBCT)
What does popcorn have to do with depression?
Sylvia Boorstein, American-author, psychotherapist, and Buddhist teacher, uses this food-based analogy to describe the mind’s powerful production-house of negative random thoughts that pop up in our heads, keeping us stuck in the past and afraid of the future.
This depressogenic and anxiogenic schemata (you now, that thinking that keeps you anxious or stuck) is the major contributor of this disorder, which is one reason why it's so tricky tho treat.
Standard treatment of depression usually entails medication or cognitive behavioural therapy (CBT), or a combination thereof. Studies indicate that 30% of patients recover from depression after their first trial with anti-depressant medication. This number increases by 20% after a second trial.
Yep, only 20%. So, what about the other 50%?
Depression that doesn’t respond to standard treatment is classified as treatment-resistant depression (TRD). Effective treatment for TRD has been a challenge.
Mindfulness-Based Cognitive Therapy (MBCT) might be the answer.
MBCT + Path D Dr. Stuart Eisendrath, Professor of Clinical Psychiatry and Director of the UCSF Depression Centre, is the doctor behind Path D - a study to treat the other 50%. He describes #depression as a time-based disease; one that causes the mind to occupy itself with the thoughts that highlight troubles of our past and fears on our future.
Eisendrath is studying the impact of #MBCT as an effective treatment for #healing TRD. MBCT integrates cognitive behavioral therapy (CBT) with mindfulness meditation. It focuses on decentering and acceptance to change thought processes rather than challenging the thought to balance it out. This teaches the individual to disengage from the disease by simply observing, letting go of resistance and fear, and ultimately changing the relationship with that emotion/feeling.
Path D involves the use of MBCT over 8 weeks for TRD. The study is a single-site, randomized and controlled clinical trial combining MBCT plus Treatment as Usual (TAU) and Health Enhancement Program (HEP) augmentation of TAU. TAU includes standard treatment for depression including pharmacological intervention. HEP is the comparator condition as a control for non-specific effects. It includes physical activity, functional movement, music therapy, and nutrition.
Eisendrath claims the study’s priority is to evaluate whether MBCT is effective in treating TRD, as well as assess whether MCBT + TAU is more effective than HEP + TAU, and finally whether MBCT treatment effects can be sustained for one year.
With the use of fMRIs, Eisendrath was able to show the before and after functional results of changes the brain as a result of MBCT.
The biological changes are creating some excitement, and indicate improved executive functioning due to an increase of activity in the dorsolateral prefrontal cortex (DPFC) and decreased activity of the ventrolateral prefrontal cortex (VLPFC). This correlates with those emotional regulation areas/systems in the brain that promote working-memory function and lift depression.
These scans support the benefits of MBCT with pharmacological intervention as an effective treatment; showing that mindfulness can help to re-wires the brain's pathways in a relatively short period of time.
In summary, and finally back to the popcorn....
Our natural tendency for the negativity bias and rumination is the monster popcorn maker that lives in our heads, keeping us from experiencing or enjoying life as it happens. A regular mindfulness practice takes us out of their heads, out of that judgmental space, and into the body as a vehicle of exploration sans judgment; simply, as a being of awareness.
This shift away from self-criticism moves the focus to compassion and acceptance - a marker of MBCT’s positive impact and one that can benefit everyone.
For more information on mindfulness and Path D Study, grab some popcorn and check him out at https://www.youtube.com/watch?v=5eQ3MWz4yrI. Dr. Eisendrath is knowledgeable, engaging, interactive and funny. You’ll even get a mini mindful mediation sampling!