Mindfulness-based cognitive therapy for depression

Abstract

Dear Editor, Mindfulness gives a sight to be aware of the present moment-by-moment sensations, emotions, thoughts, and experiences with a non-judgmental attitude.[1,2] Practitioners of mindfulness learn to live in the present moment and not travel in the past or future with their emotional interpretations of events which leads to pain in life. This technique is helpful in patient groups to overcome their depressive feeling, emotions, and behavior.[3-6] Two approaches of mindfulness that are widely evaluated and effective are Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). MBCT and MBSR both are also effective in clinical depression. Practicing it decreases the risk of relapse in depression.[1-3] A, 30 yrs old female, post-graduate, married, Hindu, Hindi speaking, belongs to middle socioeconomic status, and from an urban area came to OPD with her husband for persistent low mood, crying spells, lack of joy in every activity, inability to perform household chores, avoiding others and try to live in her room alone, hopelessness, worthlessness, disturbed sleep and appetite from last three months. She was treated with antidepressants by a Psychiatrist with gradual response and referred for psychotherapy. A detailed interview showed that the patient’s illness was precipitated by her repeated failure to get her desired job. Strained relationships and conflicts with her in-law also contribute to maintaining her problems. Due to her husband’s job, they had to live far away from their native place leading to a sense of loneliness, lack of support, avoidance behavior, and poor motivation for activities. She was assessed with the Beck Depression Inventory (BDI), Hopelessness Scale of Beck et al.[4] (HSB), and WHOQOL-BRIEF at baseline, after 8 weeks of therapy sessions to understand the efficacy of Mindfulness-based cognitive therapy, and again after a follow-up period of next one month to know the durability of the management [Table 1].Table 1: Shows the pre-, post, and follow-up assessment scores of the patient on BDI, HSB, and WHOQOL-BRIEFHer scores on BDI suggest a severe level of depression at baseline. High on all domains of the hopelessness scale suggests a sense of hopelessness, negative expectations, and low motivation for the future. After intervention and in follow up she showed improvement in depressive symptoms and have hope in her life. Scores on WHOQOL-BRIEF were found low in baseline assessment on all domains. Anxiety and depression contribute to worsening the quality of life of sufferers due to poor support, lack of functioning, poor health, and low mood. Post-intervention scores were suggestive of improved quality of life in the patient which was maintained in follow-up. She improved in all domains of quality of life after intervention. Previous studies supported the result that MBCT provides an improvement in depressive symptoms, relapse prevention, and quality of life in patients with depression.[5-7] Depressive symptoms are colored with lots of negative emotions and cognitions, distorted ways of evaluation of self, others, and events, judgmental thinking, and pessimism. MBCT effectively deals with depressive symptoms. The results propose that depressive symptoms can be healed by disengaging from distorted cognition and restructuring it, increasing attention to the present moment through mindfulness exercises. It is a promising treatment for turning down the severity of depression and improving quality of life. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Author’s contribution Concept, design, definition of intellectual content, literature search, data acquisition: DK, NS Manuscript preparation: DK, NS. Manuscript editing and manuscript review. DK. Guarantor: DK. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.