SSRIs May Have Met Their Match—How Mindfulness Is Shifting The Narrative In Anxiety Treatment

I don’t know about you, but I know a lot of people who have been on Lexapro, past and present. It’s the gold standard for selective serotonin reuptake inhibitors (SSRIs), and despite antidepressant prescriptions being at an all-time high, it turns out that SSRIs in general aren’t doing much to improve people’s overall quality of life. In fact, researchers think SSRIs are being overprescribed by clinicians, and up to 85% of people who are on them get the same amount of mood improvement from placebo pills.

Knowing how ineffective and even damaging SSRIs can be for the minds, bodies, and souls of many Americans, it was an honest relief to read that Georgetown University Medical Center researchers recently put the efficacy of SSRIs to the test against alternative, behavioral treatments like mindfulness exercises. Their discovery is major for mental health discourse: Mindfulness-based practices can be just as effective as SSRIs for managing anxiety.

Let’s Take a Look at the Study

Georgetown conducted a randomized clinical trial with 276 patients. Some were instructed to treat their anxiety with escitalopram (or Lexapro), while others were instructed to try mindfulness-based stress reduction programs (MBSR). The MBSR program consisted of both weekly two-and-a-half-hour in-person classes and daily at-home practices. It’s worth noting that more women were sampled than men, but that could actually work in the study’s favor since women tend to report experiencing anxiety more than our male counterparts.

MBSR as a technique was developed over four decades ago by a scientist, professor, and writer named Jon Kabat-Zinn. Kabat-Zinn based MBSR on ancient Buddhist vipassana mediation principles and has had success training Olympic athletes, CEOs, clergy, judges, lawyers, businessmen, and more in meaningful mindfulness practices. Turns out, what worked well for those individuals can work well for anyone looking to better their mental health treatment.

The Director of Anxiety Disorders Research Program at Georgetown University Medical Center and first author of the study, Elizabeth Hodge, MD, explained that this new data is proof for the healthcare industry to recommend mindfulness-based stress reduction as a viable treatment for anxiety.

“A big advantage of mindfulness meditation is that it doesn’t require a clinical degree to train someone to become a mindfulness facilitator. Additionally, sessions can be done outside of a medical setting, such as at a school or community center,” Dr. Hodge stated.

One of the participants claimed that revamping her relationship with MBSR techniques was transformative and changed how she responded to the world around her. “It gave me the tools to spy on myself. Once you have awareness of an anxious reaction, then you can make a choice for how to deal with it,” she said.

Mindfulness requires the practitioner to be committed and consistent, since results aren’t as immediate as pills.

Past research, like a 2014 meta-analysis of research on the positive effects of mindfulness practices like meditation for psychological stress-related health problems, had suggested a moderate improvement in anxiety and depression. While the researchers at that time didn’t find any evidence that meditation was more effective than active treatments (exercise, behavioral therapies, drugs), they did admit that stronger studies would be needed. Stronger studies have now shown just how much mindfulness can reduce the severity of anxiety symptoms. 

I wouldn’t be surprised if people write off these findings because Big Pharma probably doesn’t want them to hear about them. Since over 300 million people are considered to have some sort of anxiety disorder (which deems anxiety the most common mental disorder du jour), there’s a lot less pharmaceutical money to be made from people who opt for mindfulness meditation over clinical treatment. 

Mindfulness meditations and practices can take place anywhere, be administered by anyone (or no one else beyond yourself), and require no barrier to entry with appointments, paperwork, follow-ups, trips to the pharmacy, and integrating pill popping into your routine. That said, mindfulness practices do require the practitioner to be committed to the routine and stick through a potentially lengthy process, since results aren’t as immediate as those pretty little pills.

We’ve Got the Receipts To Prove It

If you pop onto TikTok for any length of time, you’re likely to stumble upon people “appropriating” mental illness and oversharing their problems with short videos. Some people genuinely have a mental disorder, but many have been called out for falsely adopting mental illness as a quirky, cute personality trait. 

Mental illness should be taken seriously, but as I have discussed before, there’s a big difference between a clinical disorder and experiencing everyday anxiety. We evolved to feel anxious as a protective tool. We’ve also got it so good nowadays that any amount of adversity might make us think we’re suffering from a diagnosable disorder.

One of our own Evie writers, Ramsha, detailed how she treated her diagnosed generalized anxiety disorder after having tried antidepressants. Her whole story is worth a read, but let me give you a few details. The medications made her gain weight and feel lethargic. She felt unhappy despite being on medications that were supposed to make her feel the exact opposite. 

Through a strong support system, regular meditation, daily exercise, increasing creative hobbies, and trying adaptogenic herbal remedies, Ramsha managed her anxiety without having to go back on SSRIs. She does note that it’s wise to consult with medical professionals before making a change to your mental health therapy, but her testimony is a great example of how this study should be taken very seriously in mental health discourse. 

So, What Constitutes a Mindfulness Routine Anyway? 

Well, mindfulness doesn’t just mean looking both ways before crossing the street. You’ve probably seen endless ads for apps like Headspace or Calm. Maybe you use one of those yourself, or even one of the more niche competitors like my favorite, Abide, a biblical take on meditation and sleep stories. You might be thinking, how in the world could a smartphone, the exact thing that makes me so anxious in the first place, actually calm my stress and anxiety? 

Recent MIT research suggests that meditation apps like Headspace can actually have just as positive an impact on your mental well-being as in-person therapy. From guided meditations, breathing exercises, calming audio, and more, using a mindfulness app can be a genuine treatment for your emotional distress that is far less costly to your bank account and body. The researchers did caution that the trial period was short, and I would caution that swapping out a pre-programmed app for treating actually debilitating mental disorders might not be wise, but this doesn’t devalue the data for the many people who have lower levels of anxiety.

Meditation apps can have just as positive an impact on your mental well-being as in-person therapy. 

It’s also worth pointing out that mindfulness tech is a trend and can’t deliver you the rigor of meditation that an in-person experience would offer. Meditation apps usually aren’t interactive, they offer cookie-cutter sessions, they don’t dig deep into the root causes of your mental imbalances, and frankly, there are so many apps out there that it’s hard to know which one works the best. 

Here are a few best practices for getting the most out of a mindfulness app. First, use it as a stepping stone and see if mindfulness practices fit into your life. Then, before you meditate, make sure to journal out some precise goals for what you want to achieve through meditation. Do you have low-self confidence? Write in your journal where you experience those feelings, what physically and mentally happens to you, how long those feelings last, and connect the dots. Journal to find the root cause, and then meditate on it.

Another way you might enjoy incorporating anxiety-busting mindfulness into your daily routine is to practice mindful movement like yoga, pilates, or tai chi. Whether you choose to practice yoga in person a few days a week at your favorite studio or you prefer at-home workouts based around pilates principles like the ones available on the 28 app, focusing on your breathwork while moving your body is a more engaging option for mental meditation than just sitting peacefully.

Want to go even further? I once tried a “psychotherapy” style breathwork class which participants swore by for healing their trauma. While that one wasn’t the right mindfulness practice for me, I have found amazing levels of lasting peace from sensory deprivation tank sessions…and trust me, they’re not as scary as they sound! Another popular healing technique that you could try is music therapy, a form of sensory therapy that might use sound baths and bowls or binaural beats to help you cool your jets. The list of mindfulness methods could go on and on.

Closing Thoughts

I’m very sympathetic to each person’s personal experience with mental illness. That said, it would appear that there’s genuine proof out there for natural remedies as a more reasonable answer to common emotional distress than getting stuck on antidepressants that could cause you to potentially feel worse, gain weight, and not address the root cause of your problems. Sure, mindfulness on its own can’t cure deep mental instabilities, but lifestyle changes would appear to rival the effectiveness of antidepressants after all!

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