Can meditation help with anxiety or depression?

A frequently asked question is whether meditation can help with anxiety or depression.

There can be many reasons for anxiety or depression — nutrient deficiencies, malfunctioning brain biochemistry, adverse life-circumstances, social isolation, physical inactivity, deep-seated trauma, and so on. Meditation can do little except provide symptomatic relief in many cases. Where meditation is appropriate, the conclusion of metastudies is that it produces small to moderate improvements in psychological health. It's best used as an adjunct to conventional treatment (psychotherapy, prescription medicine) rather than as a treatment by itself. [1]

There was a lot of interest in mantra meditation in the 1970s. The actual technique may not matter much. Jonathan Smith at Roosevelt University showed that sitting still with your eyes closed is just as effective as Transcendental Meditation. [2], [3] The control group in his study practiced an invented form of meditation called "Periodic Somatic Inactivity." The instructions for PSI went like this:

Sit up straight in your chair. Place your feet flat on the floor. Place your arms in a position that is comfortable for you. If you are carrying a handbag or package, put it aside. Now, simply close your eyes and sit for the next 15 to 20 minutes. Remain physically inactive for this period of time; that is, sit still and avoid unnecessary movements. Let your mind do whatever it wants. Whatever you do mentally will have little or no impact on the effectiveness of the technique. The important thing is to remain physically inactive. Do not talk, walk around, or change chairs. You may engage in an occasional action such as shifting your position or making yourself more comfortable. And you may scratch. At the end of the session, open your eyes, breathe deeply a few times, and continue with your everyday activities.

What's important is that you sustain your meditation practice every day over the long term. Over half of both Smith's TM group and his PSI group dropped out of the study. Either you must be internally motivated and disciplined, or you need to build an external support network of teachers and fellow meditators. It helps to choose a practice you enjoy and are naturally drawn to.

Certain kinds of meditation — Mindfulness Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT) — are specifically designed to treat mood disorders. Since this is their explicit purpose, it's reasonable to think these might have the best chances of success. In addition, they have been tested in controlled circumstances and the results published in peer-reviewed journals. [4], [5]

One problem in extracting meditation practices out of broader traditions is that you're assuming they are "detachable techniques." [6] The Buddha himself did not teach meditation; he taught the Noble Eightfold Path. Meditation was only one part. Similarly for Christian Meditation. The assumption is that you are a Christian first and a meditator second. The meditation is an optional way to express your relationship with Jesus. If all you do is practice meditation, you risk missing something of vital importance.

The metastudies mentioned earlier report averages of averages. Individual results are going to vary from these averages. Some people do really well with meditation; others see no results at all or even increased anxiety. You can't tell in advance which category you'll fall into. The only way to be sure is to try it.

The controlled studies necessarily involve relatively modest amounts of meditation. You can find anecdotes where people have achieved much better results with much more practice. For example, there's a thread on Reddit, "How I defeated my 20 years of anxiety disorder with 5 hours meditation a day." [7] This, of course, is just one individual. There are no systematic studies where people commit such huge amounts of time.

An interesting example of body-awareness therapy appeared some years ago on the Dharma Overground: [8]

About 4 months ago, I entered a depressive phase. I began doing something which, at the time, felt like a "last resort." I was astounded to find what I'd done written practically word-for-word when I read MCTB [Mastering the Core Teachings of the Buddha] a few days ago:
"Try this little exercise the next time some kind of strong and seemingly useless or unskillful emotion arises. First, stabilize precisely on the sensations that make it up, and perhaps even allow these to become stronger if this helps you to examine them more clearly. Find where these are in the body, and see as clearly as possible what sorts of images and storylines are associated with these physical sensations. Be absolutely clear about the full magnitude of the suffering in these, how long each lasts, that these sensations are observed and not particularly in one's control."
Lying down, I stayed with these "sadness" emotions for a long time, say 30 minutes, and would fall asleep "into" them each time, which would give strange dreams connected to the themes.
I have decent concentration. The book [Mastering the Core Teachings of the Buddha] showed me that I had already mastered first jhana; I just didn't know what it was called. So I could stay on these emotions solidly and would get a combined visual and feeling of them. I mainly experienced them as movement. I just ignored any storylines that arose as I could stay solidly with the emotions.
After about three of these sessions, I remember sitting at my computer and something triggered one of those "sad thoughts." I closed my eyes, found the emotions doing the exact same thing as they had done in the session, and they no longer bothered me at all.
That was 4 months ago, and I have not had a single "depression" ever since. A lot of stuff in my life got lighter. I started waking up happy. I also found I could make plans for the future without the cloud of depression looming in the distance. It felt like my entire life turned around for the better.

Suggested follow-up

Since MBSR and MBCT are backed up by research, use a search engine to find local and online courses on MBSR and MBCT. [9] The standard course lasts eight weeks.

Notes

[1] Sy Atezaz Saeed, Karlene Cunningham, and Richard M. Bloch, "Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation," American Family Physician, vol. 99 no. 10 (2019), pp. 620-627.

[2] Jonathan C. Smith, "Psychotherapeutic Effects of Transcendental Meditation with Controls for Expectation of Relief and Daily Sitting," Journal of Consulting and Clinical Psychology, vol. 44 no. 4 (1976), pp. 630-637.

[3] The techniques of TM are taught by official instructors only. For instruction in TM-like techniques, see Yogani's Deep Meditation and Joanie Higgs' Effortless Deep Meditation. The TM mantras are documented at http://minet.org/mantras.html, and the checking notes and steps to initiation are on the same site at http://minet.org/checktoc.html. The likely source of the TM mantras is chapter 26 of John Woodroffe's Garland of Letters: Studies in the Mantra-Shāstra (Madras: Ganesh; London: Luzac, 1922) and/or the section "18. Bija Akshara" in Swami Sivananda's Japa Yoga: A Comprehensive Treatise on Mantra-Sastra (Rishikesh: Sivananda Publication League, 1942).

[4] Bassam Khoury, Manoj Sharma, Sarah E. Rush, and Claude Fournier, "Mindfulness-based stress reduction for healthy individuals: A meta-analysis," Journal of Psychosomatic Research, vol. 78 no. 6 (2015), pp. 519-528.

[5] So-An Lao, David Kissane, and Graham Meadows, "Cognitive effects of MBSR/MBCT: A systematic review of neuropsychological outcomes," Consciousness and Cognition, vol. 45 (2016), pp. 109-123.

[6] Anna Lutkajtis, The Dark Side of Dharma, London: Aeon Books, 2021.

[7] "How I defeated my 20 years of anxiety disorder with 5 hours meditation a day! The story," https://www.reddit.com/r/Meditation/comments/k7k059/how_i_defeated_my_20_years_of_anxiety_disorder.

[8] https://www.dharmaoverground.org/discussion/-/message_boards/message/5566891

[9] See also the literature, e.g. Zindel Segal, Mark Williams, and John Teasdale, Mindfulness-Based Cognitive Therapy for Depression (New York: Guilford Press, 2018).