Mindful Medication

A Path to Cognitive, Emotional and Physical Well-being
Steven M. Savlov, Ph.D.

PAYING ATTENTION ON PURPOSE WITHOUT JUDGEMENT is the definition of mindfulness, according to Jon Kabat-Zinn, Ph.D., director of the Mindfulness Based Stress Reduction (MBSR) program at the University of Massachusetts Medical Center. Interestingly, one does not have to be a Buddhist or even religious to access the benefits of mindfulness meditation, although it does help to be somewhat spiritual. Since 1989, over 18,000 patients with various diagnoses (e.g., chronic pain, congestive heart failure, diabetes, MS, and AIDS) have participated in MBSR at the University of Massachusetts Medical Center with meaningful results.

The MBSR program, now offered throughout North America, Europe and South America, involves attending a two-hour-per-week, eight-week set of classes and engaging in 45 minutes of mindfulness meditation at home on a daily basis. Overall, research suggests that MBSR can produce marked improvements in autoimmune functioning, memory and cognitive processing, as well as depression and anxiety. Three recent studies are of particular interest. First, in a 2010 study, Dr. Dharma Singh Khalsa of the Alzheimer’s Research and Prevention Foundation in Tucson, AZ, found that cognitively impaired individuals who spent 12 minutes daily meditating had increased blood flow to the frontal and parietal lobes, areas of the brain involved in retrieving memories, and showed improvements in neuropsychological measures of language, memory, attention, and overall cognition. Additionally, as demonstrated by Dr. Sara Lazar of Massachusetts General Hospital and her colleagues, cognitively normal adults who practice mindfulness mediation show increased grey matter density in the left hippocampus, an area of the brain critical for learning, memory and emotional control, as well as in structures associated with self-awareness, compassion and introspection. Mediators in this study also had decreased grey matter density in the amygdala, an area involved in the stress anxiety response. Interestingly, the latter finding correlated with the mediators’ own reports of reduced stress. And, finally, in a 2003 study by Dr. Richard Davidson at the University of Wisconsin and his collaborators, healthy employees practicing mindfulness meditation showed significant increases in both left-sided anterior activation of the brain, a pattern associated with positive affect, and immune response to the influenza vaccine.

Given the beneficial effects of practicing mindfulness meditation on the brain and overall well-being, I now regularly recommend meditation and other positive lifestyle practices, such as exercise, hobbies, and a healthy diet, to my patients. As a neuropsychologist, I have been particularly struck by the under-stimulating lifestyle patients seeking cognitive, memory and/or mood assessments frequently practice. For many of these patients, a typical day would involve watching favorite television shows between breakfast, lunch, dinner, and bedtime. Engaging these patients in mentally and physically stimulating activities helped to alleviate their depression and anxiety. Similarly, mindfulness meditation has the potential to benefit people with Mild Cognitive Impairment, Alzheimer’s disease, or other dementias. Rather than relying on anti-dementia medications alone, health care professionals and caregivers can enhance the health and overall well-being of cognitively impaired individuals through a variety of non-pharmacological interventions, including mindfulness meditation. As well, caregivers may find exercises like the one below helpful for themselves to reduce stress. 


A SIMPLE MINDFUL MEDITATION EXERCISE:

Find a comfortable chair, couch, cushion or bed and take a relaxing position, either sitting up or lying down. You can also do this exercise standing up. Notice the position you are in, such as sitting on the chair; feel the back of the chair supporting your upper back and the bottom of the chair supporting your buttocks and pelvis area. Feel the support under your feet given by the floor. Take some relaxing, regular breaths – not too deep and don’t hold your breath. With your eyes open or closed (except if standing up), notice the movement of the breath as the chest and stomach expand on the in-breath, much like a balloon being blown up, and deflate on the out-breath. Experiencing the in and out of the breath is almost like riding the waves of the ocean. Notice how effortless and rhythmic the movement of the breath is and the pause in between in-breaths and out-breaths. After about five breaths, you will probably notice yourself starting to relax. You will also probably notice some thoughts distracting you. Treat your thoughts like clouds in the sky; they are just thoughts passing through, riding the air currents. You can use your breath as an anchor or home base to come back to as you let go of your thoughts. You can do the same with body sensations, such as discomfort where you notice it; breathe with the discomfort to soften it and then let it go as you come back to the breath. Some people find it helpful to count their breaths with the out-breath, that is, silently count each out-breath for up to five out-breaths and then start counting again. It is suggested that you start with daily practice for ten to fifteen minutes and expand the time as your skills and schedule allow.


 

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