Mindfulness involves focusing attention on present-moment experience with curiosity, openness, and acceptance. This review describes three mindfulness interventions effective for psychiatric symptoms and pain: Zen meditation, mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT). Zen is a Buddhist tradition, while MBSR and MBCT are secular, manualized clinical methods. Studies indicate that MBSR and MBCT have broad-spectrum antidepressant and antianxiety effects and reduce general psychological distress. MBCT is strongly recommended as an adjunctive treatment for unipolar depression. Both MBSR and MBCT show efficacy for anxiety symptoms. MBSR benefits general psychological health and stress management in medical, psychiatric, and healthy individuals. MBSR and Zen meditation aid pain management.
Long-term opioid therapy for chronic pain can lead to anhedonia, or reduced ability to experience pleasure from natural rewards. A behavioral intervention called Mindfulness-Oriented Recovery Enhancement (MORE) was tested in 63 veterans on long-term opioid therapy for chronic pain, who were randomly assigned to eight weeks of MORE or a supportive group therapy. MORE increased brain and physiological responses to natural reward cues and reduced subjective anhedonia more than the control. The reduction in anhedonia was linked to increased brain activity during savoring of rewards. MORE may be an effective treatment for anhedonia in chronic opioid users and those at risk for opioid use disorder.
Among people receiving Mindfulness-Oriented Recovery Enhancement for opioid misuse, those who showed higher levels of endogenous theta brainwave activity during meditation subsequently required lower doses of opioids. Theta oscillations, which are linked to relaxation and focused attention, may serve as a neural marker predicting treatment response.
Veterans who completed mindfulness-based interventions through the Veterans Affairs Health Care System reported seeking treatment for trauma, health concerns, depression, and anxiety, and they experienced benefits in depressive symptoms, anxiety, health concerns, and pain levels. More than half maintained a daily mindfulness practice 6 to 12 months after treatment. Different types of mindfulness interventions showed comparable long-term outcomes, but demographic variables correlated with different results. Presenting certain mindfulness skills early and building daily practice throughout treatment may help veterans access effective components and reduce dropout.