09 Jun How does Mindfulness Helps Anxious Brain to Calm Down? A Scientific Review

Dr. Shanthi Lakshmi Duraimani, Ph.D., Bangalore

It’s normal to feel anxious when facing a challenging situation, such as a job interview, a tough exam, or a blind date. But if your worries and fears seem overwhelming and interfere with your daily life, you may be suffering from an anxiety disorder. There are many different types of anxiety disorders and many effective treatments and self-help strategies. Once you understand your anxiety disorder, there are techniques you can take to reduce your symptoms and regain control of your life.

Mindfulness was hypothesized to impact anxiety by changing individuals’ relationship to thoughts (Teasdale, Segal, & Williams, 1995). Teasdale et al. (1995) suggest that mindfulness allows adults to take a decentered approach to thoughts that elicit worry and panic, meaning anxious thoughts become temporary and are no longer viewed as reflections of reality. For example, thoughts can be seen at transient; they come and go, and are not a static part of one’s identity (Teasdale et al., 1995). In turn, this leads to reductions in rumination and increases in emotional regulation (Lykins & Baer, 2009; Ramel, Goldin, Carmona, & McQuaid, 2004; Teasdale, Segal, & Williams, 1995). As a result, mindfulness gives individuals the ability to learn to identify and manage their feelings of anxiety and learn how to react to them effectively (Hazlett-Stevens, 2012). These findings support the hypothesis for how mindfulness can impact anxiety.

In recent years, there has been a steady stream of research showing the power of mindfulness meditation to reduce anxiety. Dr. Elizabeth Hoge, a psychiatrist at the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital and an assistant professor of psychiatry at Harvard Medical School, says that mindfulness meditation makes perfect sense for treating anxiety. “People with anxiety have a problem dealing with distracting thoughts that have too much power,” she explains. “They can’t distinguish between a problem-solving thought and a nagging worry that has no benefit.”

“If you have unproductive worries,” says Dr. Hoge, you can train yourself to experience those thoughts completely differently. “You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that a thought, and not a part of my core self,’” says Dr. Hoge.

One of her recent studies published in the JAMA Internal Medicine review found that a mindfulness-based stress reduction program helped quell anxiety symptoms in people with generalized anxiety disorder, a condition marked by hard-to-control worries, poor sleep, and irritability.

Although, ample research evidence shows the effectivity of mindfulness on anxiety, the brain mechanisms involved in meditation-related anxiety relief were unknown.  So, researchers at Wake Forest Baptist Medical Center have decided to determine the effectiveness of mindfulness in reducing anxious brain activity. They published a study titled “Neural Correlates of Mindfulness Meditation-Related Anxiety Relief” in the journal Social Cognitive and Affective Neuroscience which identifies brain regions activated by mindfulness meditation.

To isolate the brain mechanisms behind mindfulness training the researchers  employed pulsed arterial spin labeling MRI to compare the effects of distraction in the form of “Attending to the Breath” (ATB) before meditation training and to mindfulness meditation (after meditation training) on the state of anxiety in test subjects.

For the study, the researchers recruited fifteen healthy volunteers with normal levels of everyday anxiety. These individuals had no previous meditation experience or known anxiety disorders. All subjects participated in four 20-minute classes to learn a technique known as mindfulness meditation. In this form of meditation, people are taught to focus on breath and body sensations and to non-judgmentally evaluate distracting thoughts and emotions.

Anxiety was significantly reduced in every session that subjects meditated. Brain imaging found that meditation-related anxiety relief was associated with activation of the anterior cingulate cortex, ventromedial prefrontal cortex, and anterior insula. These areas of the brain are involved with executive function and the control of worrying. Meditation-related activation of these three regions was directly linked to anxiety relief.

Activation of the anterior cingulate cortex the area that governs thinking and emotion—is the primary region believed to influence a decrease in anxiety. These findings provide evidence that mindfulness meditation attenuates anxiety through mechanisms involved in the regulation of self-referential thought processes.

Anxiety relief during ATB was associated with greater activity in areas such as the left putamen (1st row). Meditation-related anxiety relief was associated with greater activity in areas such as the anterior insula, ACC and the ventromedial medial prefrontal cortex (vmPFC; 2nd row). Increases in state anxiety were associated with increased PCC activation (2nd row). ATB-related anxiety changes were associated with activation in PCC, middle frontal gyrus, hippocampus, lateral occipital lobe and the right putamen when compared to meditation-related anxiety changes (3rd row). When contrasted to brain regions involved in ATB-related anxiety changes, brain regions involved in meditation-related anxiety alterations were found in the ACC, anterior insula, putamen and SII (4th row). Note: fMRI series with noxious stimulation were not included in analyses corresponding to the first two rows. One noxious stimulation series, per condition (3rd row: rest + neutral, rest + heat, ATB + neutral, ATB + heat; 4th row: rest + neutral, rest + heat, meditation + neutral, meditation + heat), was included in the analyses corresponding to the last two rows of the figure.

Anxiety is a cognitive state connected to an inability to regulate one’s emotional responses to perceived threats. Mindfulness meditation strengthens a person’s cognitive ability to regulate emotions. “Although we’ve known that meditation can reduce anxiety, we hadn’t identified the specific brain mechanisms involved in relieving anxiety in healthy individuals,” said Fadel Zeidan, Ph.D., postdoctoral research fellow in neurobiology and anatomy at Wake Forest Baptist and lead author of the study. In this study, they were able to see which areas of the brain were activated and which were deactivated during meditation-related anxiety relief. Further research needs to be done in order to understand the specific brain mechanisms involved in reducing anxiety.

References

1. Lykins, E. L. B., & Baer, R. A. (2009). Psychological functioning in a sample of long-term practitioners of mindfulness meditation. Journal of Cognitive Psychotherapy, 23(3), 226-241.
2. Ramel, W., Goldin, P. R., Carmona, P. E., & McQuaid, J. R. (2004). The effects of mindfulness meditation on cognitive processes and affect in patients with past depression. Cognitive Therapy and Research, 28(4), 433-455.
3. Teasdale, J. D., Segal, Z., & Williams, J. M. G. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behaviour Research and Therapy, 33(1), 25-39.
4. Zeidan F1, Martucci KT, Kraft RA, McHaffie JG, Coghill RC. Neural correlates of mindfulness meditation-related anxiety relief..Soc Cogn Affect Neurosci. 2014 Jun;9(6):751-9. doi: 10.1093/scan/nst041. Epub 2013 Apr 24.
5. http://www.helpguide.org/articles/anxiety/anxiety-attacks-and-anxiety-disorders.htm.
6. http://www.health.harvard.edu/blog/mindfulness-meditation-may-ease-anxiety-mental-stress-201401086967.
7. http://archinte.jamanetwork.com/article.aspx?articleid=1809754.
8. https://www.psychologytoday.com/blog/the-athletes-way/201306/how-does-meditation-reduce-anxiety-neural-level.