Childhood trauma and PTSD symptoms are linked to worse depression outcomes and more meditation-related adverse effects in mindfulness-based programs. Across two clinical trials, total childhood trauma and childhood sexual abuse consistently predicted poorer depression outcomes. Childhood sexual abuse also predicted dropout in one study. Multiple forms of trauma and PTSD symptoms predicted meditation-related side effects, while total trauma, emotional abuse, and subclinical PTSD predicted lasting adverse effects. These findings suggest that trauma-sensitive modifications, safety monitoring, screening, and provider education are needed when implementing mindfulness programs for depression.
Buddhist meditation is traditionally described as a state of relaxed alertness that avoids both excessive hyperarousal (restlessness) and excessive hypoarousal (drowsiness, sleep). While modern research has emphasized meditation's relaxing and hypoarousing effects, this review draws from Buddhist texts and scientific studies—including subjective, behavioral, and neuroimaging data during wakefulness, meditation, and sleep—to show that meditation also has arousing or wake-promoting effects. Factors such as dose, expertise, and contemplative trajectory influence whether meditation increases or decreases arousal. The course of meditative progress suggests a nonlinear multiphasic trajectory: early effortful phases may produce more fatigue and sleep propensity, while later stages yield greater wakefulness due to neuroplastic changes and more efficient processing.