Millions of people around the world suffer from anxiety and anxiety disorders. Anxiety disorders include social anxiety disorder, panic disorder, generalized anxiety disorder, and phobias. These are all characterized by excessive, often irrational worry and fear. Other conditions, including depression, obsessive-compulsive disorder, and post-traumatic stress disorder are closely linked to anxiety. All of these conditions can significantly interfere with everyday life, and they are significant risk factors for substance use and addiction.
The good news is that anxiety disorders and related disorders are treatable. Medications such as SSRIs have shown to be effective in controlling anxiety, as has psychotherapy, such as cognitive behavioural therapy, or CBT, and dialectical behavioural therapy, or DBT. For anyone who struggles with anxiety or anxiety disorders, mindfulness can be a valuable addition to her mental toolbox. In fact, DBT always includes mindfulness training as a way of dealing with challenging emotions. And a hybrid of CBT and mindfulness, called mindfulness-based cognitive therapy, or MBCT has proven effective in preventing relapses in people with recurring depression.
Simply put, mindfulness is being aware of what’s happening without judging it. You keep your attention in the present without ruminating over past mistakes or worrying about the future. You simply accept and observe whatever is happening around you and inside you. This is easier said than done. Our natural tendency is to escape pain and pursue pleasure. If we don’t like something, we either want to change it, destroy it, or escape it. This is especially true for people who are used to being in charge and solving problems. The notion that you can just let the anxiety be and not try to fix it feels like defeatism.
However, anxiety doesn’t doesn’t work like most problems. If you try to avoid it, ignore it, or suppress it, it only gets worse. Somewhere deep down, your brain believes your are in danger and it wants to be sure you’re ready. If you try to ignore the message, it only becomes more urgent. There is also research that shows you can’t avoid thinking about something. At some level, your brain has to keep track of what you’re not supposed to think about. Therefore, the anxiety is always there. And if you try to avoid situations that make you anxious, you only increase your fear of that sitation.
Mindfulness takes a different approach. By acknowledging the anxiety and observing it instead of trying to push it away, you may not get rid of it, but you reduce the power it has over you. We typically over-identify with our emotions to the extent that we’re not even aware that we can choose how to respond to them. For example, if you feel anxious, you most likely think, ‘I am anxious’. Practicing mindfulness helps you find the space between what’s happening and how you respond to it.
Say for example, that you’re in an unfamiliar situation and you begin to feel anxiety. One possibility is that you identify with the anxiety, try to push it away, feel even more anxious and become overwhelmed by it. Another possibility is that you acknowledge it and treat it as information. Your response might be, ‘Oh, there’s anxiety again. It’s telling me to remain alert in this unfamiliar situation. Message received’.
There is compelling evidence that mindfulness meditation helps reduce anxiety. One review of 47 rigorous clinical studies on mindfulness meditation found strong support for moderately improving symptoms of anxiety in participants. The typical study lasted less than eight weeks, and it’s likely that longer practice yields greater effects.
One imaging study found that eight weeks of mindfulness practice was enough to physically change the brain. Images showed that the amygdala, the brain’s fear center, had shrunk by the end of the eight-week course. Images also showed that the prefrontal cortex, the part of the brain responsible for judgement, self-control, and planning, had become thicker. What’s more, the amygdala became less connected to other regions of the brain, but more connected to the prefrontal cortex, indicating greater control over fear-related emotions. The longer you practice mindfulness meditation, the more pronounced these changes become.
These studies show that practicing non-judgmental awareness of anxiety and other challenging emotions is not just a psychological trick. It actually makes you physiologically less capable of anxiety. Of course, this takes regular practice. It doesn’t really work to say to yourself, ‘Ok, the next time I have to deal with a difficult situation at work, I’ll just observe my anxiety non-judgmentally and then I won’t panic’. In the heat of the moment, the anxiety will probably be too intense. You have to make mindfulness a regular practice.
You can learn techniques and do guided sessions with your therapist or in a class, but you still have to practice at home. For most people, especially those with anxiety, anxious thoughts and feelings will spontaneously arise while you’re sitting quietly by yourself. This is the time to practice being with those feelings, watching them, accepting them, and not trying to push them away. This is when you notice what kinds of thoughts–often grossly inaccurate thoughts–accompany your feelings of anxiety. Not only will you gradually learn to accept whatever you happen to be feeling, but you will discover that you don’t have to believe everything you think. This is why mindfulness is a powerful complement to CBT. It lets you experience your thoughts as suggestions, which you are free to alter or ignore.
If you or someone you love struggles with anxiety or depression, The Dawn Medical Rehab and Wellness center can help. We are one of Thailand’s most respected addiction treatment and wellness centers. We use cutting-edge treatment modalities, including mindfulness and CBT to provide personalized care to treat addiction, depression, anxiety, bipolar disorder, personality disorders, PTSD, and executive burnout. See our contact page to reach us by phone or email.