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Anxiety disorders can be all-consuming, highly distressing, and cause simple daily tasks or interactions to feel nearly impossible. It is estimated that nearly one-third of U.S. adults will experience an anxiety disorder at some point in their lives. These anxiety disorders include social anxiety, post-traumatic stress disorder (PTSD), agoraphobia, panic disorder, separation anxiety, generalized anxiety, and obsessive-compulsive disorder (OCD). The symptoms that come along with anxiety disorders can make it difficult to be successful in both one’s personal and professional life, as it can affect their relationships, mood, goals, level of motivation, and more. The mental, and even physical, toll that anxiety can take on one’s overall well-being makes finding the right treatment a necessity.

“It is estimated that nearly one-third of U.S. adults will experience an anxiety disorder at some point in their lives.”

While the specific treatment for different types of anxiety disorders may vary, it is common for a patient to receive a prescription for a selective serotonin reuptake inhibitor (SSRI) to treat symptoms. More than 1 in 10 people in the United States are taking an antidepressant, oftentimes to help treat an anxiety disorder. SSRIs are the most frequently prescribed antidepressant, specifically escitalopram. Escitalopram is the generic name for Lexapro, a commonly prescribed SSRI used to treat depression and/or anxiety disorders.

With this high percentage of individuals taking medication for treatment, it is likely that everyone probably knows a few people who are taking an SSRI to treat their anxiety disorder. Taking medication may seem like a simple solution to treat a disorder, but not everyone responds well to it. Common side effects of taking SSRI medications can include gastrointestinal issues, interrupted sleep, sexual dysfunction, dizziness, headaches and even worsened anxiety. These side effects can interfere with daily life and make medication an unreliable treatment option.

In hopes of finding an alternative solution to treating anxiety disorders, a team of researchers led by Elizabeth A. Hoge, MD, who is the director of the Anxiety Disorders Research Program at Georgetown University Medical Center, conducted a randomized clinical trial to understand how mindfulness-based stress reduction compared to escitalopram for the treatment of anxiety disorders in adults.

Mindfulness-based stress reduction (MBSR) is an 8-week meditation therapy designed to reduce stress and allow oneself to become more aware of their own body. It combines breathing exercises and intentional movements, encouraging one to be more present and aware of the moment. MBSR is widely used amongst clinicians to help reduce stress, but often thought to be more of a complementary treatment. This study opens up the possibility of it being equally effective as medications in the treatment of anxiety disorders.

In the study, there were 276 adult participants, 156 of them (75%) being female, with a mean age of 33 years old. The group consisted of a variety of different races/ethnicities with the majority of the participants (59%) being White, 20% being Asian, 15% being African American, 9% being Hispanic/Latino and 6% being of another race or ethnicity.

All study participants had an untreated, current and primary diagnosis of an anxiety disorder. The anxiety disorders of participants included in the study were generalized anxiety disorder, social anxiety, panic disorder or agoraphobia. Anyone who had a lifetime diagnosis of bipolar disorder, psychotic disorder or OCD were excluded from the study. Exclusion criteria also included any individual who had a current diagnosis of anorexia/bulimia nervosa, PTSD, substance use disorder or who was actively partaking in severe suicidal ideation and/or behaviors.

Eligible participants were screened to ensure they had not participated in any MBSR trainings within the past year or had an ongoing daily meditation practice. Participants were also not allowed to be taking psychiatric medications, apart from controlled and stable doses of trazodone, sleep medications such as zolpidem and eszopiclone and benzodiazepines.

The researchers split the participants into two separate groups, one receiving the escitalopram and the other practicing MBSR therapy, both throughout the course of 8 weeks. Participants in the escitalopram group were given a standard, low level dose of Lexapro. They started treatment at a 10 mg dose and then increased to 20 mg by week 2 if they were tolerating it well. They checked in with a medical doctor or nurse practitioner at weeks 1, 2, 4, 6 and 8 over the course of 8 weeks. Many of the study participants in the escitalopram group experienced uncomfortable side effects such as nausea.

The MBSR group was put on an 8-week long program with classes led by qualified instructors. The participants attended weekly classes at community sites or clinics for 2.5 hours, participated in an all-day retreat weekend class during either week 5 or 6, and practiced home exercises for 45 minutes daily. They practiced a variety of forms of mindfulness such as breathwork, body scans, intentional movements and meditations.

At the end of the 8 weeks, both groups reported a decrease in the severity of their anxiety symptoms by about 20%. Their research found that MBSR was an equally effective treatment option compared to escitalopram in adults diagnosed with anxiety disorders. Not only did MSBR have the same effectiveness in treating anxiety disorders, but it was also very well-tolerated with better responses from the patients.

“Their research found that MBSR was an equally effective treatment option compared to taking escitalopram in adults diagnosed with anxiety disorders.”

Their findings bring about exciting new possibilities to the approach in the treatment of anxiety disorders. This research provides evidence that medication is not always the best treatment that mental health professionals can provide for their patients with severe anxiety. While MBSR and escitalopram can complement each other quite well, MBSR is shown to be equally as effective, making it a great alternative for someone who may be experiencing negative side effects of medication. Additionally, MBSR is a safe therapy option and more widely available.

“This research provides evidence that medication is not always the best treatment that mental health professionals can provide for their patients with severe anxiety.”

The study has its limitations, such as individuals in the MBSR group spending more time attending to the treatment of their anxiety, but overall, it draws attention to the importance of utilizing MBSR courses and trainings. This opens up new possibilities for individuals dealing with untreated anxiety who may have not responded well to medication or have developed unpleasant side effects in the past.