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Meditation vs. Medication: How Mindfulness Can Help with Anxiety

I was excited to read a recent article in JAMA Psychiatry[1] showing that mindfulness-based stress reduction exercises had the same benefit as the drug escitalopram (brand name Lexapro) on anxiety. The mindfulness techniques used in the study included both at home and class based exercises, such as breath awareness, body scanning, and mindful movement, for a total of 3 hours and 45 minutes per week. This is the first study of its kind comparing meditation to the effects of a drug on anxiety, and the effects were equal!

So for 30 minutes per day practicing techniques that provide only positive effects on the body, one could also potentially avoid taking an oral medication with numerous potential side effects ranging from decreased libido to impaired sleep to seizures, just to name a few.

The results of this study should mean that practitioners treating anxiety discuss these techniques as a viable treatment option with their patients. And maybe if that happens, we see improvement in other related issues, like depression and obesity. Think about how much differently the world could look if we all took 30 minutes a day practicing simple and low to no cost mindfulness techniques? What if our kids did this? There could be so much less suffering and so much more health.

Sadly, I also read that semaglutide (brand name Wegovy) was approved by the FDA to treat obesity down to age 12. I say “sadly’ because while having a drug that reduces obesity and its associated complications is fantastic, wouldn’t it be best to just not need this drug? Should we not instead be inundated with messaging about the importance of nutrition, stress management, movement and mental health in our kids?

The answer is of course yes, however our culture and medical system are completely broken and at odds with our actual health. If I had a dollar for every time a patient told me that I am the first doctor to bring up nutrition with them, and I am a dermatologist. And this includes my patients with heart disease and diabetes. But this is not because their other doctors do not care; it is because their hands are tied by a medical system that does not value these conversations and the time they take. What we are inundated with is marketing and messaging for unhealthy processed foods, meat and dairy, backed by corporations that only care about their bottom line. And of course, the government is involved as well through various lobbies related to the food industries. But I digress.

I say the phrase “it is all related” to my patients all the time. The health of your body is related to the health of your mind, and if your mind is healthy, you are able to make better choices for your body.

This is why self care matters.

[1] Hoge EA, Bui E, Mete M, Dutton MA, Baker AW, Simon NM. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial. JAMA Psychiatry. 2023;80(1):13–21. doi:10.1001/jamapsychiatry.2022.3679

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