Treatments That Work: The Impact of Mindfulness-Based Cognitive Therapy on Major Depressive Disorder
Depression is a widespread and debilitating mental health issue with profound consequences for individuals, society, and the economy (Kessler et al., 2003; König et al., 2020; Moussavi et al., 2007). A key feature of depression is the diminished ability to experience positive affect and positive emotions, with anhedonia (a reduced interest in or pleasure from previously rewarding activities) being a central symptom of the condition (Dunn, 2012; Dunn, 2019).
Dunn and colleagues aimed to explore alternatives to the most common approach to depression which is Maintenance antidepressant medication (M-ADM) (Moriarty et al., 2020). The reason to explore alternatives is because taking antidepressants can have several downsides, including struggles to repair anhedonia and M-ADM requires lifelong maintenance to remain effective (Moriarty et al., 2020, Alsayednasser et al., 2022; Dunn et al., 2020).
This study focuses on the potential effectiveness of Mindfulness Based cognitive therapy with support to taper from antidepressant medication (MBCT - TS) as an alternative to M-ADM, in reducing the risk of Relapse. The alternative is also focused on prioritizing positive affect levels (Dunn et al. 2024) given that low levels of positive affect have been shown to predict an increased risk of depressive relapse/recurrence in the past (Dunn et al. 2020, 2024).
Results:
Dunn et al, found that MBCT-TS shows strong potential as an alternative to M-ADM for minimizing depressive relapse in individuals with recurrent depression. MBCT-TS was found to significantly boost positive affect, which includes feelings like joy and contentment, compared to M-ADM. As positive affect plays a key role in guarding against relapse, individuals with higher baseline positive affect levels were shown to have greater resilience. This indicates that the therapy not only supports medication tapering but also enhances emotional well-being, helping reduce the risk of relapse
Nevertheless, the study has its limitations. It remains uncertain whether improvements in positive affect were directly due to MBCT-TS, the tapering process, or a combination of both. Furthermore, the participant pool was predominantly white individuals from Britain, which may restrict how broadly the findings can be applied. Despite these challenges, the results align with existing theories emphasizing the importance of positive affect in fostering resilience. Enhancing future MBCT-TS programs by focusing more on strategies to cultivate positive affect could amplify its effectiveness.
Why this Matters:
These results are important because they strengthen the validity of alternative treatments for depression that reduce risk of relapse. This is especially useful for patients that don’t wish to take medication the remainder of their lives. To taper off of M-ADM’s without increasing the risk of relapse, can be very important to people, as M-ADM’s can be a financial burden and can create serious side effects. Additionally, this literature provides promising evidence for holistic approaches, which work to bridge the gap between eastern medicine and western philosophy.
Author:
Mason Bradford, Emory University
Editor:
Elaine Johnson, PhD.
Article Reviewed:
Dunn, B. D., Warbrick, L., Hayes, R., Montero-Marin, J., Reed, N., Dalgleish, T., & Kuyken, W. (2024). Does mindfulness-based cognitive therapy with tapering support reduce risk of relapse/recurrence in major depressive disorder by enhancing positive affect? A secondary analysis of the PREVENT trial. Journal of consulting and clinical psychology, 92(9), 619–629. https://doi.org/10.1037/ccp0000902
