What mindfulness and meditation are
The National Center for Complementary and Integrative Health (NCCIH) describes meditation as a group of practices that calm the mind, often by focusing on a particular sensation such as the breath, a sound, an image or a repeated word. Mindfulness means keeping attention on the present moment without judging it. You can practice mindfulness in a formal seated meditation, or informally while washing dishes or walking the dog.
The NHS puts the core idea plainly: paying attention to what is going on inside and outside ourselves, moment by moment. That includes body sensations and surroundings, and also thoughts and feelings as they come and go. With practice, the NHS says, people can learn to notice when thoughts are taking over and see them as mental events that do not have to control them.
Structured programs build on this. NCCIH describes mindfulness-based stress reduction (MBSR), which teaches mindful meditation along with discussion and ways to apply it to stress, and mindfulness-based cognitive therapy (MBCT), which combines mindfulness practice with elements of cognitive behavioral therapy.
What the research shows
The evidence is encouraging but more modest than some marketing suggests.
- A 2014 review in JAMA Internal Medicine by Goyal and colleagues looked at 47 trials with more than 3,500 participants. It found moderate evidence that mindfulness meditation programs improved anxiety, depression and pain, with small to moderate effects. It found no evidence that meditation was better than other active treatments such as medication, exercise or other behavioral therapies.
- NCCIH describes a 2018 analysis of more than 12,000 participants with diagnosed conditions such as anxiety or depression. Mindfulness-based approaches were better than no treatment and worked about as well as established treatments such as cognitive behavioral therapy and antidepressants.
- For anxiety disorders specifically, NCCIH reports a 2021 analysis with mixed results: only some mindfulness approaches were as effective as cognitive behavioral therapy, and studies that followed people for more than two months found no long-term effects.
- For recurrent depression, a 2016 analysis by Kuyken and colleagues pooled individual data from nine trials and nearly 1,300 patients. People who received MBCT had a lower risk of depressive relapse over about 60 weeks than those who did not, including compared with other active treatments.
NCCIH also cautions that much of the research is preliminary, studies use many different practices, and results may have been interpreted too optimistically. The NHS notes that UK guidance recommends mindfulness-based therapies as a way to treat less severe depression.
Is it safe?
NCCIH says meditation and mindfulness are usually considered low risk, but few studies have examined harms carefully. It describes a 2020 review in which about 8 percent of participants had a negative effect from meditation, a rate similar to that reported for psychological therapies. The most common negative effects were anxiety and depression.
The NHS says the same thing in everyday terms: many people find mindfulness helpful, but it is not right for everyone, and some find it does not help or makes them feel worse. For people who have been through trauma, long inward focus on the breath or body can sometimes stir up distress. Grounding Strategies: What They Can and Cannot Do describes outward-focused options and what to do if a technique makes things worse.
Simple ways to start
You do not need an app subscription or an hour a day. The NHS suggests a few everyday practices:
- Notice the everyday: the taste of your coffee, the cold air when you step outside, the feel of the steering wheel.
- Keep it regular: pick a set time, such as your morning commute or a lunchtime walk, to pay attention to your senses.
- Name thoughts and feelings: silently label them, such as "Here's the thought that I'll mess this up" or "This is anxiety."
- Move if sitting is hard: the NHS notes some people find a busy mind easier to manage during gentle yoga or walking.
For a short formal practice, sit comfortably, set a timer for five minutes, and rest your attention on the feeling of breathing. When your mind wanders, which it will, notice where it went and gently bring it back. The NHS describes this kind of practice and stresses that mindfulness is not about making thoughts go away. The wandering and returning is the practice, not a sign you are doing it wrong.
If you want a class or program, NCCIH suggests asking about the instructor's training and experience. It is also reasonable to ask about the approach, the time commitment and what to do if a practice feels upsetting.
Where mindfulness fits with anxiety and depression
Mindfulness can be especially useful for patterns that live in the head. It gives you a way to notice rumination or worry without following it, and the NHS suggests it can be particularly helpful when you realize you have spent several minutes reliving past problems or rehearsing future ones. Rumination: How to Step Out of Repetitive Negative Thinking covers that loop.
It is less likely to be enough on its own when depression is severe, when anxiety is stopping you from working or leaving home, or when there are thoughts of suicide. NCCIH is direct: do not use meditation or mindfulness to replace conventional care or as a reason to delay seeing a health care provider, and tell your providers about the approaches you use.
Mindfulness-based therapies such as MBCT are specific, structured programs. If you want one, ask any therapist or program about their training in it. In anxiety therapy, Dr. Lehmann, a licensed clinical psychologist in Franklin, works in an insight-oriented, integrative way: practical help calming the body and settling worry, alongside understanding where the pattern came from.