According to the U.S. Department of Health and Human Services, prescription drug spending is expected to rise to $457.8 billion in 2019 from its current amount of $274.5 billion. With sobering numbers like these, it's no surprise why benefit plan sponsors and participants are continually seeking ways to cut medication costs.
Antidepressants are one of the most commonly prescribed category of drugs in the nation. But recent scientific studies are pointing to powerful alternatives to psychotropic medications. In a December 2010 article published in the Archives of General Psychiatry, researchers described how mindfulness-based cognitive therapy prevented depression relapse among 84 subjects who had suffered from major depression. Dr. Zindel Segal, Ph.D. and his colleagues concluded that "for those unwilling or unable to tolerate maintenance antidepressant treatment, MBCT offers equal protection of relapse during an 18-month period."
What is MBCT?
Mindfulness-based cognitive therapy was developed by Zindel Segal, Mark Williams, and John Teasdale. At its core, MBCT is a form of meditation - a practice that traces it origins to the beginning of human civilization.
Dr. Zindel and his colleagues took 84 subjects whose ages ranged from 18 to 65 years old. They all had experienced two bouts or more of major depression, and they had been in remission for over six months. Each of the adults received one of the following three treatments:
1. Antidepressant medication
2. Mindfulness-based cognitive therapy
3. Placebo
Eighteen months later, Dr. Zindel and his team followed up with the participants. They measured the results of the entire group, as well those who had the highest degrees of depression.
They defined the subjects with the most elevated levels as participants who scored seven or higher on the Hamilton Rating Scale for Depression. The study's findings were most striking for this group. The relapse rate was 28% for those who were treated with MBCT, 27% for those who were treated with antidepressants, and 71% for those who were administered the placebo.
Dr. Zindel and his colleagues concluded that MBCT was virtually as successful at preventing depression relapse as psychotropic medication.
Implications for health care industry
The study has significant implications for the health care industry. "Prescription medication accounts for 20% or more of medical expenses, and cutting medical costs reduces premiums across the board," says Hilary Myers, vice president with Benefits and Incentives Group, a benefits consulting firm located in Denver, Colo. "So meditation and other successful alternatives can reduce costs and improve the health and wellbeing of employees."
I've been in private practice as a licensed clinical psychologist for over 20 years and I'm a longtime meditator as well. I encourage all my clients to implement meditation into their lives because of its ability to not only decrease bouts of depression, but because it's safe, has no side effects, and is simple to do.
In recent years, the scientific community is showing unprecedented interest in meditation, and it is confirming what I've seen in my practice. My clients who regularly meditate have experienced results that parallel Dr. Zindel's subjects.
So how does it work? A cause and effect relationship provides a straightforward explanation. Most health care experts agree that a significant cause of illness is stress, and meditation is one of the most powerful ways to reduce stress. Decrease your stress and you feel better.
Are you a Toyota or a Ford?
Stress isn't the cause of every illness. But many common ailments can be attributed to it. Imagine that our bodies are automobiles, where each car's brand is like a person's DNA. Just like we can't turn a Toyota into a Ford, there's not much we can do to alter our genes.
What if, every day, we slam on our brakes continuously, never change our oil, and overlook all maintenance? At first, our bodies may not reveal signs of damage. Over time, however, the neglect will show - sometimes subtly and other times dramatically. If we are Toyotas, perhaps the result will be a transmission in disrepair.
If, on the other hand, our bodies are Fords, our transmissions may be fine but our brakes will no longer function. Similarly, everyone has genetic predispositions particular to himself or herself.
In the end, we're all going to wear out, but the speed and how that deterioration manifests itself will be different for each person. Regardless of our own DNA, however, reducing stress significantly elevates our chances of living longer and experiencing less wear.
Meditation gives our minds a break
We can have intense jobs and deal with difficult matters both in and outside of work. But if we meditate regularly, we can still experience peace of mind regardless of our responsibilities.
To illustrate, think of meditation like you would the work breaks you take every day. If you had to exert yourself eight hours continuously, without relief, your time at work would eventually become unbearable. But lunchtime and breaks throughout the day allow you to make it through.
Similarly, meditation gives your mind time off from constant mental activity. There are numerous studies that measure the brain waves of longtime meditators. These people have an ability to relax their minds to the alpha, theta, and delta brain waves, which are usually associated with sleep. Over the long term, meditation reduces overall stress, and this, I believe, is one of the main reasons that it also decreases depression relapse.
The nation's current health care crisis has added a new dimension to the old saying, "Prevention is the best medicine." With rising copays, high deductibles, confusion over coverage, and prescription drug headaches, plan sponsors and participants realize that getting sick is more complicated than ever.
So if illness is rapidly becoming cost-prohibitive, then we need to consider all wellness practices that have been scientifically proven to be effective. No doubt, there's a place for prescription medication. But for those who are undergoing treatment for depression, a wide body of evidence is pointing to a practice that is free and can be put into effect right away.
Dr. Robert Puff, Ph.D. is a clinical psychologist based in Newport Beach, Calif. He has been in private practice for over 20 years. Puff is an author, meditation expert, international speaker and the creator of the weekly Meditation For Health Podcast, available at
