A Study Shows Mindfulness Is Non-Inferior to SSRI for Anxiety Disorders And What the Heck Does That Mean?

I ran across this study showing Mindfulness Based Stress Reduction (MBSR) is “noninferior” to escitalopram in the treatment of adults with anxiety disorders.

I passed my Biostatistics course in medical school—barely. I have been practicing MBSR daily (for the most part) since 2014 when I really needed to address my struggle with burnout. I’m probably a worrier but I doubt I have a clinically significant anxiety disorder. I’m admittedly biased in favor of MBSR. Otherwise, I wouldn’t still be practicing it after about 10 years.

On the other hand, I don’t have a great handle on the statistical concept of noninferiority in clinical studies. I found a little YouTube presentation on it and I think I’m a little more comfortable with it now. I said “a little bit.” I’m not taking questions.

Reference:

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

Loving-Kindness Meditation in the Real World

Today is the first day of Martin Luther King, Jr. Human Rights Week and I’m giving a shout-out for acts of kindness as well as the Loving-Kindness meditation. A neighbor with a snowblower helped clear our driveway a couple of weeks ago. A couple of days ago he did the same for his next-door neighbor. I’m going to go out on a limb and speculate the city snowplow driver was kind enough to avoid plugging the driveways on our street. No kidding, we watched the snowplow use what was obviously a different plowing technique which left our driveways relatively clear of snow.

The Loving-Kindness meditation is a mindfulness practice that Dr. King would probably have supported. It’s a way to send love to yourself and others, including those with whom you might be in conflict—even your enemies. King might say, “Now is the time” for something like that.

I’m reestablishing my mindfulness and exercise practice after a several month lapse. I first took the Mindfulness-Based Stress Reduction (MBSR) course several years ago through The University of Iowa Hospitals and Clinics. It made a difference in how I approached problem-solving and conflict. I was on autopilot most of the time and wrote a blog post about my experience before and after my mindfulness training experience, “How I left the walking dead for the walking dead meditation.”

Part of that program included instruction on the Loving-Kindness meditation. I’m still a beginner at mindfulness, although my approach to life is still ironically more like the expert’s in Shunryu Suzuki’s quote:

“In the beginner’s mind, there are many possibilities, in the expert’s mind there are few.”–Shunryu Suzuki

I need to keep working on being more open to different ideas, interpretations, and ways of getting things done—approaching challenges with a beginner’s mind.

One recent challenge is hanging pictures. Sena and I hung a picture yesterday. I wanted to measure everything and she wanted to estimate. She had misgivings about my measurements but went along with it. After the picture was hung, even I had to admit it was not in the right spot. Funny thing, after a short while, she admitted that the misplacement was not that far off and that she was getting used to it. If you’ve ever hung pictures, you know I’m leaving out a lot of the back-and-forth negotiation about how we finally arrived at that middle ground. It involved loving kindness on both sides.

We’ll see how the next picture hanging goes.