Meditation and breath

Meditation for Anxiety: Does It Help?

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Structured mindfulness programs can help. In a 2022 trial of 276 adults with diagnosed anxiety disorders, an eight-week mindfulness-based stress reduction (MBSR) course was found to be noninferior to escitalopram, a standard first-line medication. Larger analyses agree that mindfulness approaches beat no treatment, though results against therapy are mixed and long-term effects are less certain.

What did the head-to-head trial find?

The TAME trial by Hoge and colleagues in JAMA Psychiatry randomly assigned adults with diagnosed anxiety disorders, recruited at three US academic medical centers, to either the weekly MBSR course or escitalopram for eight weeks:

  • Main result: MBSR was noninferior to escitalopram on anxiety severity rated by clinicians who did not know which treatment each patient had.
  • Completion: 208 of the 276 participants completed the trial.
  • Side effects: 10 people in the escitalopram group, 8 percent, dropped out because of adverse events, compared with none in the MBSR group.

“Noninferior” means MBSR was not meaningfully worse than the medication by a margin set in advance. It does not mean MBSR was better.

What do larger analyses show?

The NCCIH summarizes two:

  • A 2018 analysis of 142 groups and more than 12,000 participants with psychiatric disorders such as anxiety or depression found mindfulness-based approaches better than no treatment, and as effective as established evidence-based treatments.
  • A 2021 analysis of 23 studies in adults with anxiety disorders found mixed short-term results: mindfulness approaches were more effective than usual treatments overall, but only some types matched cognitive behavioral therapy. The risk of bias was unclear in all the studies, and the few that followed people for more than two months found no long-term effects.

How might meditation ease anxiety?

By changing how you meet anxious thoughts rather than trying to stop them. In mindfulness practice, a worry is noticed as a thought passing through, observed without judgment, and allowed to go. That is a skill, and like the MBSR course itself, it is learned through regular practice over weeks.

Is it a replacement for treatment?

Not automatically. The TAME results apply to a structured eight-week course led by trained instructors, not to an app or occasional practice. If you have an anxiety disorder, discuss options with your clinician, and do not stop a prescribed medicine without their guidance.

Choosing a program

If you want to try meditation for anxiety, look for a structured course such as MBSR, taught over several weeks with home practice, rather than starting alone. Ask the teacher about their training and how they handle participants who feel worse during practice. Then track your anxiety on a simple weekly scale so you and your clinician can see whether it is helping.

This article is general information, not medical or psychological advice; talk with a licensed clinician about your own situation.

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