Several complementary and alternative treatments have been used for depression. Two of these, acupuncture and mindfulness, are discussed here. Although mindfulness is discussed in this section, one mindfulness intervention — mindfulness-based cognitive therapy (MBCT) — has been studied extensively and is generally considered to be a mainstream treatment for depression.
Acupuncture is a traditional Chinese medicine approach. It involves inserting thin needles into the body at acupuncture points. Acupuncture is commonly used for pain relief, but some studies have been published investigating its effectiveness for depression. Results of studies have been inconsistent, but there is some evidence that it may be beneficial when combined with antidepressants.
Mindfulness and Meditation
Mindfulness meditation has been shown to be an effective intervention for depression. Mindfulness refers to a mental state that can occur while practicing meditation or at any time or place in the course of one’s daily life. The concept of mindfulness can be perplexing, but it is in fact a very simple idea. Mindfulness is simply keeping one’s attention focused on what is happening in the present moment.
One way that mindfulness can be understood is by contrasting the mindful to the non-mindful state of mind. In the non-mindful state, the mind automatically focuses attention. In the language of mindfulness, this is known as autopilot. Autopilot thinking is focused on the past or the future, rather than the present moment. It often includes irrational or excessively negative thinking patterns. Autopilot thinking generally increases depressive symptoms.
In contrast, when practicing mindfulness, attention is directed on the sights, sounds, thoughts, emotions and actions that are occurring at the moment. Thus, mindfulness involves developing the ability to focus attention on the here and now and observing each moment with curiosity, openness and acceptance. It is particularly important to develop a nonjudgmental awareness of one’s thinking patterns.
The concept of mindfulness meditation was developed from Eastern religious and philosophical thought, particularly Buddhism. That said, there is nothing inherently religious about meditation or mindfulness.
Meditation simply refers to specific practices that can include mindfulness meditation. These practices are aimed at keeping one’s attention under conscious control rather than on autopilot. One practices mindfulness meditation to develop the ability to spend more of life in a state of mindful awareness.
Mindfulness-Based Cognitive Therapy
One of the most studied clinical mindfulness interventions, mindfulness-based cognitive therapy (MBCT) was developed specifically for the prevention of relapses in recurrent depression by Zindel Segal, Mark Williams and John Teasdale. There is considerable evidence of benefit for depression and other psychiatric conditions. The strongest evidence is for relapse prevention in major depression, particularly among those with three or more prior episodes. Furthermore, MBCT offers protection against relapse equal to that of maintenance antidepressant medication. Evidence also suggests efficacy for those experiencing a current episode as well as for those in remission. One study indicates that MBCT is as effective as CBT in the treatment of current depression.