Social anxiety disorder is more than just shyness…

Social anxiety disorder is more than just shyness or nervousness.  Many people get nervous or self-conscious on occasions, yet Social anxiety disorder involves intense fear of certain social situations—especially situations that are unfamiliar or in which you feel you’ll be judged by others; and where are afraid that you won’t measure up or that you will be exposed as inferior.  The thought of such situations may cause you to get anxious just thinking about them and you may go to great lengths to avoid them, disrupting your life in the process.

Social anxiety is a bigger problem than you might expect.  It is estimated that up to 13% of American adults will have social anxiety that reaches clinical proportions in their lifetime…. In the UK Social Anxiety Disorder is estimated to affect between 10% and 15% of subjects in the community at some time in their lives.  It is more prevalent in women.

Research has shown that social phobias often start in adolescence and are centred around a fear of scrutiny by other people in comparatively small groups, often peer groups, and  leads to the avoidance of social situations. Sometimes, there may be specific problems such as eating in public, public speaking, or encounters with the opposite sex; or, they can involve almost all social situations outside the family circle. A fear of vomiting in public is not uncommon.

Here’s a quick test – the Mini Spin test:    Score yourself: 0 = not at all, 1 = a little bit, 2 = somewhat, 3 = very much, 4 = extremely – a score 6 or more suggests a social anxiety problem:

  1. Fear of embarrassment causes me to avoid doing things or speaking to people.
  2. I avoid activities in which I am the centre of attention.
  3. Being embarrassed or looking stupid are among my worst fears.

In the UK, NICE suggest that social anxiety can be treated by cognitive behavioural therapy (CBT) or by drugs. Physical symptoms may include: nausea and stomach complaints; sweating ;trembling and muscle tension; difficulty talking to others; immense fear of talking in public; avoiding public spaces and social situations; difficulties making friends and avoiding meeting new people; fear of being judged or watched by strangers; cancelling plans at last minute; and panic attacks

To be clear social anxiety is not the same as being introverted.  While introverts may seek to avoid attracting attention to themselves or may wish to avoid appearing precautious and prefer to have time to consider and reflect on things… this is very different actually fearing some up-and-coming social situation… often weeks in advance.

Now, there may   be some situations which are dominated by people making a show of their intelligence or their experience and this can be intimidating and cause significant anxiety about saying or doing the wrong things… or being exposed as in experienced or stupid.    Indeed the British class system can often intimidate those who feel they don’t fit in to a group… and so may say or doing something that make then look foolish

People with social anxiety are often low on self-esteem – or have a low feeling of self–worth.

So what can be done if you experience social anxiety? Well there are coping strategies – to strike up a conversation, or to find people to talk to; or to ensure you have the option to quit an uncomfortable situation.  You can say to people you meet that you find the gathering daunting (…this is empowering). One drink can make you feel more relaxed – but more can make yopu do things you might regret and just increase your “hangxiety”! Yet these tricks don’t address the core problem.

Better to acknowledge the dynamics that make may you feel uncomfortable.  Imagine being in a situation where everyone else is so eloquent and seems to knowledgeable – almost competing to demonstrate how much they know or how successful they are.  Perhaps you think they may make snide remarks about those who that feel are not “on their level”.  Extroverts may have big egos – or they may be trying hard to project their status or expertise to overcome their own self-doubt or lack of self-confidence – so when someone behaves in this way spend time reflecting on which of these motives might be causing them do so.

Yet there is no shame in not knowing about something.   So, ask how people got started – ask for advice on where you should start; say that things seem so intimidating yet you want to learn.  If someone is rise then simply say – I am trying to find out more… it is not very generous to make fun of others.

Now, there are lots of websites with tips to help you to comp in social situations  – here are some tips listed in the Huffington Post to help you keep calm in a social situation.

Yet rather then just “cope”… it seems to me, that becoming more aware of the issues that may cause you to feel anxious may be a better way to go – there is a very helpful self-help guide here .

And finally, I come back to the issue of low self–esteem .  It may not be to everyone’s’ taste but I have noted that work of psychologist Marisa Peer seems very relevant here. She suggests that we are often influenced and affected by incidents and actions from the past … yet these are no longer relevant.   Here is an interesting piece from the “livingfaithoverfear” blogg by Kara (“Elementary Teacher, Writer, and Spirit Junkie”).  It is a good introduction to power of the “I am enough” mantra.

40% of young adults exhibit perfectionist tendencies – it’s not good!

I have been thinking about perfectionism.

Some of my friends won’t start a project or a piece of work because they believe it won’t “be perfect” – so they have a kind of “perfection paralysis”.  Yet “perfectionism” runs much deeper than that this – and it can lead to serious problems in the lives of those prone to it. And worryingly, perfectionism is on the rise.  So what is it and why does this rise matter?

Perfectionism is the desire to produce work, or to perform,  to high standards – not necessarily a bad thing – yet, for perfectionists, any failure to meet such expectations can cause them to feel frustrated or angry or even that they can “never be good enough” – often leading them to “quit the field”; and worse, perfectionism is linked to  the development of conditions like depression, anxiety, eating disorders and self-harm…  and it is linked to suicide.

You see perfectionists tend to “beat themselves up” for mistakes or for any failure to reach their high standards.  Yet we know that for those striving to become elite performers in some field – maths, sport, performing arts etc –  then it is important to practice just outside their current level of performance – making failure a part of the learning journey so that they are “stretched to improve”.  I wrote some months ago about Shizuka Arakawa who worked to become an Olympic gold skater;  yet she had, over the years, fallen on her butt some 20,000 times… and got up again. ( )

IMO, it may not be “high standards”… but having “unrealistic short-term expectations” that cause perfectionists to react negatively to “coming up short”.  Rather than see setbacks as an opportunity to learn and to focus on what needs to be righted, a perfectionist, may just see it as evidence that they can “never be good enough”.

So perfectionism is a problem for those who wish to make progress and is also bad for their mental wellbeing… and perfectionism is one the rise.  Research shows around 40% of young adults exhibit perfectionist tendencies – like being concerned over mistakes, feeling like you are never good enough, having critical parents, or simply having high personal standards – and these tendencies can predict issues like depression, anxiety and stress.

Even worse, being self-critical leads to depression which makes self-criticism harsher – i.e. a downward spiral. Further,  perfectionists are more likely to think about suicide; and that that nearly every perfectionistic tendency is correlated with “thinking about suicide more frequently”.

So why is Perfectionism growing?  Well, failure is so severe in today’s society. Competition has been embedded in schools: parents are putting more pressure on themselves and on their children to achieve more and more… so that  kids become averse to mistakes.  Researcher Thomas Curran says “If children come to internalise the idea that we only can define ourselves in strict, narrow terms of achievement – then you see perfectionistic tendencies start to come in.”  If Kids learn that they only get praised when they do something well; or  that they’re only really worth something when they’ve had others’ approval; or if kids feel guilty for making a mistake… then these messages  make children more likely to become  perfectionists – and go on to develop depression.

Plus “Fear of Failure” is getting magnified in other ways… the rise of social media means that any mistake or poor results is so public.

So what can be done to if you are showing perfectionist tendencies?  Well, it seems that the most important thing is to talk with others – to gain some objectivity and to set realistic short-term expectations;  to recognise progress; and to accept that failure is an important part of learning and improvement.  Maybe talk with a teacher, a coach or a friend about where you are; what you have learned from any recent setbacks and the short-term progress you now think it reasonable to make… so that you can reset your short-term expectations.

Secondly, you must show yourself some self-compassion – if a friend was trying to achieve something and failing, you would point out the positives, recognise their effort, suggest that they work on any weaknesses and encourage them by saying that you’re confident that, with effort, they will succeed.  So why not offer this advice to yourself?

And finally, boost your self-esteem.   Focus on the distance you have come – and bear in mind that your progress to date demonstrates how you will always improve will effort.

Standards are still required for university mental health practices

Starting university can be challenging – students are stressed by high expectations – their own and those of others – yet there are students must adjust to a new way of life: new leaning methods,  living in halls yet often without any friends – it’s is easy for some to just hide away.

Ceara Thacker, 19, committed suicide in her halls of residence at the University of Liverpool in May 2018. She had previously attempted to kill herself by taking an overdose. Her family were not told of the earlier suicide attempt. Iain Thacker, Ceara’a father, insisted it would have “made a difference” if they had known about an overdose just three months earlier. Some universities are trialling an opt-in scheme, whereby students allow the authorities to tell their parents if they develop problems, to help ensure their families know and can help to support them… yet not all.

It seems that there is little monitoring of the wellbeing of students – and not way to catch any sudden deterioration.  Surely our universities could recognise that families can provide significant support to students experiencing difficulties – the impact of  preventing such support can be devastating.  Why is it not already mandatory, that as part of enrolling at a college, a student must register a family member to be notified of [specified] serious health issues?

The problem of student mental health issues is rising – and quickly . A survey of 2,573 first-years, conducted by Unite Students, found that 17 per cent of respondents reported suffering from anxiety, depression or another mental health condition – up from 12 per cent in 2016. Yet only 23 per cent said they trusted their university to provide them with the right level of support.

This week, Sir Norman Lamb, the ex-health minister, published the results of his research to show that students with mental health problems are being forced to wait up to 12 weeks for help from their university…  prompting fears that some may take their own lives during the delay – as reported in The Guardian:

Undergraduates at the Royal College of Music in London had to wait the longest to start counselling last year, with the worst case being 84 days. “Twelve-week delays to start counselling are scandalous, particularly when we know that so many students are taking their own lives,” said Sir Norma. “That’s longer than a university term. It’s extraordinary that some universities are subjecting students to such long waits and failing their student populations so badly. Universities with these long waiting times need to remember that students suffering from mental health conditions very often need help as a matter of real urgency. The risk is that their mental welfare will decline even further while they wait and wait for care and support.”

That average delay of seven-and-a-half weeks was seen at the University of Bristol despite its mental health support for undergraduates coming under scrutiny as a result of the suicide or suspected suicide of 12 students there in the last three years.

The Guardian reports:  “Universities have been heavily criticised for the mental health provision they offer undergraduates, as the number of them seeking help has soared in recent years. Students’ struggles can lead to them dropping out, doing poorly academically or killing themselves. An estimated 95 students in higher education took their own lives in the 12 months to July 2017 in England and Wales… Reported student mental ill-health has increased fivefold since 2010. Research has found that one in five (22%) students has been diagnosed with a mental ailment and that even more (34%) have struggled with a psychological issue with which they felt they needed professional help. In addition, 45% use drink or drugs to help them cope with problems, 43% worry often or all the time and 9% think about self-harming often or all the time.”

Tom Madders, campaigns director at the charity YoungMinds, was quoted by The Guardian: “It is very worrying that there is considerable variation in the level of mental health support offered at universities around the country. Counselling for students should not be a postcode lottery. Many young people start university expecting to have the time of their lives. But for some it can be a stressful experience: moving away from home, financial difficulties, problems with your course, making new friends and changes to your support network can all pile on the pressure.”

So when is the Department of Education,  perhaps through its the Office for Students, going to impose safeguards and minimum standards to be delivered by universities – insisting on  disclosure to a nominated contact and establishing minimum referral times?

The BBC quoted a spokesman for Universities UK – some kind of grouping of Universities –  said: “Funding to support mental health services at universities will vary depending on the needs of each student population. Universities cannot address these challenges alone. The NHS must provide effective mental health care to students, and Universities UK is working closely with NHS England to ensure that commitments in the NHS long-term plan are implemented.”

Hmmm… it sounds like they are passing the buck. I wrote about this before… back in july 2018: Student mental health must be top priority – Universities Minister Sam Gyimah says issue requires serious leadership from vice-chancellors .  The then Universities Minster, Sam Gyimah, was calling for  the universities to introduce as schemes to notify the families of students experiencing problems – and yes, he seemed to be suggesting that the universities were not accepting a leadership role in sorting things out.  Worryingly, the quote from the universities (in the form of “Universities UK mental health in higher education advisory group”)  suggested the that they were passing the buck even then.  Yet how many more suicides will it take before the universities to step up?

High Stakes Decision Making

I wrote recently about how the US Special Forces have adopted training in mindfulness to help soldiers make better decisions in chaotic situations… to be able to focus and avoid distraction.  (See “Focus in the midst of chaos- US Special Ops” )

This set me thinking about how to help people make better decisions when the stakes are high.

I’m talking about “crisis management”… coping with disaster scenarios… or having make significant calls: stop, go, invest, expand, closedown, buy, sell or hold.

Clearly mindfulness is part of the solution… together with a few other techniques that can help also:

So the first thing: you must be able to focus and to avoid distraction.

You must set aside emotional reactions… and certainly avoid becoming overwhelmed.

And you must set aside thoughts about the “weight” or significance of the current situation… sure, you‘ll need to balance the likelihood and the impacts of success or failure associated with the choices you have…  but this should be approached with  a cool dispassion.

Further, to make the right decisions in the current situation, you should set aside the emotions and reactions from previous situations… good or bad. Every situation is different and you must assess the current issues that you face rather than be influenced by the past.

Mindfulness practice will help you with each of these…. you should try it.

So what else?

In preparation, you should ensure that you are aware of your biases… such as any tendency to take reassurance from “confirmation bias” (that seeks confirm your current understanding but may cause you to ignore evidence that might suggest your understanding may be incorrect) or “cognitive dissonance” (where the presence of evidence that contradicts your understanding causes you to reframe your interpretation of the facts to keep most of your theory intact).

Other biases may cause you to be overly confident in your own ability, or the ability of your team, to carry out necessary tasks.  So you need to talk regularly with colleagues about any biases that you may have (…“sense checking” you opinions).

Build trust… in your systems… indicators… and especially in your colleagues. … in tough times you will need to focus in your task in hand and not start to question things.  Assess the reliability for these regularly… and if you can’t develop that trust then change things now.

And of course you need to trust yourself… all you have to do is achieve this or that; and so focus on doing the things that are required… and visualise moving to a successful outcome.

There are a couple more things that I believe you need to consider:

Don’t feel undo pressure to respond.  When something seismic happens, many organisations look to their leader to make the call – so a leader may see it as their role to jump in and act.  But this is not always the best response especially when a situation is unclear or the corollary of any of the available actions is unclear.  A while ago I wrote how mindful leaders in such situations should set aside ego and emotions and reframe the need to act as curiosity – to investigate what is happening and to reach out for the opinions of others. (See “Transformational change – Leadership … and reframing ambiguity as curiosity!” )

You’ll need to manage your own behaviour.  Your reactions, your demeanour and your decisions will be noted by your staff and colleagues who may, rightly or wrongly, believe that the true “you” emerges when you are under pressure.  This may have a lasting impact on their opinion of you; on their loyalty to you and on their willingness to go the extra mile for you.  So, try to remain positive and relaxed. .. not irritable or tense.  Empathise with those working hard and let them know you are trying to limit the impact on them. Sometimes, when I have been in such a situations, all I could do was stay with the team and buy the pizzas.  And be generous… the words “please”, “thank you” and “good job” – they’re free and yet so valuable.

Then there’s the “Moral imperative of leadership”. You should act with integrity and ensure that your decisions and actions are moral… even when a situation is desperate. It is unlikely that staff will remain loyal if they believe your actions are not honest and fair.  I once attended to a talk by Stormin’ Norman Schwarzkopf who was the commander of Desert Storm… the first gulf war.  In that role he was literally asking troops to put their lives on the line.  In such a situation he said it was essential that they were in no doubt that he was doing his best to limit the dangers and that he was taking the best possible care of every one of his troops.  Fortunately most of us do not deal with decisions that can bring life or death… but I am sure the same values are key for all of us.

And finally – don’t choke – easier said than done!  Choking is when a person becomes overwhelmed with the enormity of the situation often causing them to consciously focus on small, trivial actions that have been automated long ago… so that they start to make “novice errors”.  Worse, such emotions can cause the release of brain chemicals that actually reduce your peripheral vision (real and metaphorical) and your ability to notice how the situation is changing.  So simply, set out the steps you have to take and focus on each step, in sequence, one at a time – giving each step your full attention until you have completed all – yet without thinking about weight of the whole situation.

You will get through this.

Stress and mental illness account for 57% of workdays lost in UK

When I talk to people about the impact of building resilience through mindfulness I like to emphasise its value to all – how mindfulness can increase the resilience in all of us to deal with pressure and with change; and make all of us more able to focus and to make better decisions; and to increase our productivity, our open-mindedness, our empathy and our life satisfaction… and there is evidence to show that teams with mindful members are more effective that those without such members.

Yet it is also important to look at how resilience can help people to deal with stress and to avoid becoming anxious or depressed – especially as  my recent work has shown that many people overestimate their reserve of resilience and so that are shocked when they suddenly start to experience problems.  And this happens to many people…

I recently noticed that the HSE (The UK’s Health and Safety Executive) have released figures for 2017/18 that show that work related stress and mental illness (anxiety and depression) accounted for over half of work place absences: 57%. (See here )

So nearly 600,000 employees now suffer from such conditions; and the data shows that the growth such problems has yet to plateau; growing by 13% from the previous year. The cost of this absence is now £8Billion per year.

A spokesperson from HSE commenting on the figures said: “The fact that work-related stress, anxiety and depression is estimated to be responsible for 57 per cent of the working days lost to ill health shows how important it is for employers to take action.”

At Carina Sciences we are working with employers to use our Rezl app to build the resilience of employees – to pre-empt such problems, to reduce the impact on those with such problems… and to enable all employees to boost their performance and life satisfaction.

Obsession with social media fuels anxiety in teenage girls

A study published in The Lancet Child & Adolescent Health suggests that obsessive social media usage is casing teen age girl to exhibit high levels of stress and anxiety.  Yet the anxiety of boys does not demonstrate a similar relationship with their social media usage.

The study of nearly 10,000 British schoolchildren aged 13-16 found that girls who checked social media multiple times a day had a 38 per cent greater risk of suffering psychological distress; it recommends that parents encourage teenagers to leave their phones downstairs when they go to bed and to get plenty of physical exercise.

The causes seem to be related both to the exposure to anxiety inducing content such as comparisons or exposure  to cyberbullying – even if it is to others – and that the time spent on social media reduces the time spent on more positive or support activities including sleeping.

The Times quoted Russell Viner, the lead researcher from the UCL Great Ormond Street Institute of Child Health: “Our results suggest that social media itself doesn’t cause harm, but that frequent use may disrupt activities that have a positive impact on mental health such as sleeping and exercising, while increasing exposure of young people to harmful content, particularly the negative experience of cyberbullying.”

Dasha Nicholls from Imperial College London, who co-authored the report, adds: “The clear sex differences we discovered could simply be attributed to girls accessing social media more frequently than boys, or to the fact that girls had higher levels of anxiety to begin with. Cyberbullying may be more prevalent among girls, or it may be more closely associated with stress in girls than in boys.”

Now all this makes sense to me – from my own experience as a parent it seems that the use of social media by girls is much more tied up with their self-representation, self-image and self-worth; while teenage boys seems to communicate “superficial drivel” – a bit like the way that guys, in a new social situation, will chat about their car journey or football rather than their current hopes and worries.

Yet these result chime with the results shown in the UK Adult Psychiatric Morbidity shows that 26 % of young women, aged between 16 and 18, have a common mental health disorder (depression, generalised anxiety, phobias or obsessions etc) compared with only 9% of men.

Now it could be that young women face different challenges to young men or it could be that something in the way we bring girls up means that they develop less resilience than boys – but I think this report on the impacts of social media usage on the lives of young girls is real food for thought.

Burnout – it’s official

A 2018 study found that 40% of U.S. adult workers were so “burnt-out” at their jobs that they considered quitting.

So now The World Health Organisation (WHO) has recognised the growing issue of corporate burnout as a medical condition, meaning that as of 2020, it will officially be identified in the International Classification of Diseases. (See here )

The WHO identifies “burnout” specifically as a “workplace issue”:  officially described as “a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed”:

“It is characterised by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and 3) reduced professional efficacy. Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”

“The new WHO classification means that workers experiencing burnout will be able to receive a medical diagnosis. Along with mental illness, workers have historically felt discouraged from discussing such issues within the workplace; yet now, due to the classification, workers may well feel emboldened to open up about the issue, therefore preventing a culture of taboo.

Key symptoms of burnout include fatigue; increased anxiety; Lack of motivation; lack of self-care and the emergence of severe health issues: typically symptoms may start with back pain, migraines and eye-strain or feeling like you’re drowning in your workload and have led to strokes and even heart attacks for some business professionals who refused to seek help.

Recent research conducted by CEO Magazine found that  70% of polled CEOs were in a severely unhealthy fitness condition, whilst 100% claimed to be suffering from some sort of stress ailment including headaches, asthma, ulcers and backaches.

I guess this WHO recognition is the start to ensuring that employers and health services focus on the phenomenon of burnout; and that those suffering from burnout are supported by their employers in the same way as those with any other health issues.

Now I expect we all have friends and family who have suddenly suffered from  “adrenal breakdown” or from the symptoms listed above – and the onset of such symptoms can often come as a shock… and be bewildering for the sufferer.  Yet a previous post shows  (here) that many people significantly over estimate their current level of resilience and so a “burnout episode” can strike from “out of the blue”.  Worse,  I have watched friends in high performing jobs start to suffer from such symptoms and then compound the situation by adding anxiety as they start to experience self-doubt and wonder how that can continue to earn at their current rate given how they feel… what will be the impact on their lifestyle and loved ones.  For many, it may be the first time that that have to admit to themselves, let alone anyone else, that they are not invincible.

The way out for those effected is often to rethink their approach to their work… and to their lives. Yet for most of us who have yet to experience burnout is it not too late to think about our priorities (…our ego), our work life balance and to take care of our wellbeing and resilience.

The Rezl Toolbox includes a tutorial and a guided mediation to help those experiencing symptoms of pressure and stress.  Please get in contact if you would like to try it.

Focus in the midst of chaos- US Special Ops


The US special forces are using mindfulness to ensure that soldiers are better able to focus in chaotic situations – for instance, to avoid civilian harm.

Yet making better decisions when under pressure… and being able to calmly concentrate on the task in hand when there is a lot going on … are skills that would enhance the performance on all of us.

I have previously seen research showing how the US military has demonstrated that  mindfulness helps soldiers to “decompress” after difficult patrols and studies  showing how mindfulness helps soldiers overcome PTSD –  even when the training is given “post exposure to the traumatic experiences” it can reduce the brain activity expended on ruminating about such previous situations and emotions. So I was intrigued then I saw this article in the New York Times here.

The piece explains that Professor Amishi Jha from the University of Miami published a paper last December on the effectiveness of mindfulness among members of the US Special Operation units.  The research shows that the soldiers are “better able to discern key information under chaotic circumstances and demonstrate  increased working memory function”; plus the soldiers report making fewer cognitive errors than those who are not trained in mindfulness.  Prof Jha points  out that members of the special forces are chosen for their ability to focus and so the fact that they experience an improvement speaks to the power of the mindfulness training.

Professor Jha added: “They ‘re the best and what they are trying to do is the hardest. When the US Special Forces do something not only does the rest of the US military pay attention, the rest of the world’s militaries pay attention”.

I guess while we can see that in a chaotic situation a soldier has to focus upon the relevant information and the decisions to be made. So I am sure Prof Jha is right and other militaries will be implementing their own programmes.  Yet there are many other types of role where such an ability to focus is key…  The ability to set aside emotions and reactions, to take on board the relevant information,  to make operational decisions and to “focus on what need to be done” is a very transferable skill indeed.

Making better decisions when under pressure… and being able to focus on the task in hand… are skills that would enhance the performance of all of us.

One in six UK adults take antidepressants – yet mindfulness can help avoid the need to take them… and can help patients give them up

Each year one is six adults in the UK are being prescribed antidepressants… yet mindfulness is just as effective and research shows it can help people to give up the antidepressants without increasing their chance of a relapse.

A piece from The Guardian (here) sets out the  “one is six” figure.  Data released under the Freedom of Information Act shows that more than 7.3 million people were prescribed antidepressants in 2017-18, 4.4 million of whom also received a prescription for such drugs in both of the two previous years.

Yet mindfulness, and especial Mindfulness Based Cognitive Therapy (MBCT), is shown to be as effective as antidepressants – with the added advantages of helping people to become more able to focus and more empathetic yet without the downsides of the antidepressants or the longer-term problem of how to come of them.

A  piece from Forbes Magazine, explains a study published in The Lancet, to back this up. (Here).  The Forbes article says:

The results from the current study were impressive: MBCT was just as effective as staying on antidepressants over the next two years following treatment: 44% of people in the MBCT group relapsed, while 47% of those in the antidepressant group did.

So MBCT was slightly more effective as medication, which is good news for those who in principle would like to go off antidepressants.

The study brings some interesting and hopeful news for those who don’t want to take medication over the long term, or who can’t tolerate the side effects. And, the authors point out, some people just prefer psychosocial treatments over drug treatments for personal reasons.

In fact our own NHS says Mindfulness (MBCT) is  “as good as drugs for preventing depression relapse”. (Here).


While apiece from Psychology Today suggests that Mindfulness (MBCT) training can assist patients who wish to avoid antidepressants and even better, it can help those who wish to give up the antidepressants.  (Here).

So The reasearch is clear:  before starting to take antidepressants patients should consider MBCT; and for those already taking antidepressants (the “one in six”) then may be MBCT can support them in giving up the pills.

Trial shows that MBCT reduces psychological distress in cancer patients

A cancer diagnosis is usually devastating for a patient and for their close family.  We can see that receiving such news is traumatic – leaving patients anxious about death and the impact upon loved ones; or fearful of the treatment or of being unable to control their emotions.  Yet the subsequent treatment phases can also be stressful, debilitating and challenging as patients may face the longer-term impact of surgery on their function and self-image…  and even the end of treatment – the “all clear” – can cause problems as families celebrate but the patients themselves are not feeling so positive as they try to process and adjust to the impact of their experience and the way in which they  have changed… and of course the anxiety of wondering if there will be a reoccurance. (See a previous blog post on this subject ).

Yet Mindfulness Based Cognitive Therapy can really help cancer patients to reduce distress.

This week I have been looking at a Dutch study on 245 patients using Mindfulness Based Cognitive Therapy  (MBCT) to reduce anxiety. Each of the cancer patients taking part in the study was categorised as experiencing “psychological distress” — I.e. demonstrating a score ≥ 11 on the Hospital Anxiety and Depression Scale (HADS).  See here.

The study compared patients treated with the usual psychological support  with those receiving an eight week course in either “therapist lead” MBCT or self-help (internet based) eMBCT.

The results demonstrated that both face-to-face and internet-based self-help mindfulness based cognitive therapy significantly reduced psychological distress in patients with cancer – reducing fear of cancer recurrence and improving mental health–related quality of life.

The result showed:

  • “Usual treatment” produced a change in mean HADS score from 17.04 at baseline to 16.37 at post-intervention
  • “Face to face MBCT” achieved a change from 18.81 to 13.25
  • and the “eMBCT group” achieved a change from 17.24 to 11.87 – almost eliminating  “psychotically distress” as defined

So, both MBCT and eMBCT significantly reduced fear of cancer recurrence and rumination and increased mental health–related quality of life, mindfulness skills, and more positive mental health compared with usual treatment.

The investigators concluded, “Compared with treatment as usual, MBCT and eMBCT were similarly effective in reducing psychological distress in a sample of distressed heterogeneous patients with cancer.”

This research is exciting for us at Carina Sciences as we are currently working on a project to help cancer patients and their carers by providing a blend of information, advice and psychological support from diagnosis through treatment and beyond.  I will keep you posted.