Mindfulness and meditation can worsen depression and anxiety

Mindfulness and other types of meditation are usually seen as simple stress-relievers - but they can sometimes leave people worse off.

About one in 12 people who try meditation experience an unwanted negative effect, usually a worsening in depression or anxiety, or even the onset of these conditions for the first time, according to the first systematic review of the evidence. "For most people it works fine but it has undoubtedly been overhyped and it's not universally benevolent," says Miguel Farias at Coventry University in the UK, one of the researchers behind the work.

There are many types of meditation, but one of the most popular is mindfulness, in which people pay attention to the present moment, focusing on either their own thoughts and feelings or external sensations. It is recommended by several National Health Service bodies in the UK as a way of reducing depression relapses in people who have experienced the condition several times.

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Enthusiasm for meditation may partly stem from a growing awareness of the side effects of antidepressant medicines and the difficulties some people report in stopping taking them. There have been some reports of people experiencing worse mental health after starting meditation but it is unclear how often this happens.

Farias's team combed through medical journals and found 55 relevant studies. Once the researchers had excluded those that had deliberately set out to find negative effects, they worked out the prevalence of people who experienced harms within each study and then calculated the average, adjusted for the study size, a common method in this kind of analysis.

They found that about 8 per cent people who try meditation experience an unwanted effect. "People have experienced anything from an increase in anxiety up to panic attacks," says Farias. They also found instances of psychosis or thoughts of suicide.

The figure of 8 per cent may be an underestimate, as many studies of meditation record only serious negative effects or don't record them at all, says Farias.

Katie Sparks, a chartered psychologist and a member of the British Psychological Society, says the figure could have been pushed up by people trying out meditation because of undiagnosed anxiety or depression. "Meditation has been found to help people to relax and refocus and help them both mentally and physically," she says.

But sometimes when people are trying to still their thoughts, the mind can "rebel", she says. "It's like a backlash to the attempt to control the mind, and this results in an episode of anxiety or depression," she says.

This doesn't mean people should stop trying the technique, she says, but instead should opt for guided meditation sessions, led by a teacher or an app with a recorded narration, which she believes is safer. "The current study could stop people participating in something which can be of benefit in the right context," she says.

Journal reference: Acta Psychiatrica Scandinavica, in press

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