Though news stories and research reports touting the benefits of meditation are everywhere these days, many people are daunted at the prospect of starting a meditation practice because, they believe, it’s time-consuming, difficult and maybe even a little bit weird. It’s actually none of those things, however.

Meditating is very simple. It can be done in many different ways – some of which are incredibly easy to incorporate into even the busiest lifestyles – and it’s the opposite of “weird.” Meditating (in whatever form you choose to do it) will make you calmer, happier and even smarter, insofar as it helps you maintain your focus. Those traits tend to make people more likeable and more successful.

Much of the research that’s been done on the benefits of meditation focus on a particular type, transcendental meditation (called TM) – largely because the organization that teaches TM has devoted significant resources to studying its efficacy. TM is a terrific program but it’s costly – most experts agree that anyone who incorporates meditation into their lifestyle will experience similar benefits.

And what are those benefits? It’s hard to know where to begin.

Meditation sharpens concentration, improves memory and helps regulate mood. It enhances creativity and reduces irritability; reduces reactivity (which improves interpersonal relationships) and helps maintain a positive outlook.

All that’s great for anyone and everyone but meditation has benefits that are particularly helpful to people who are suffering, for instance from the pain of addiction. Meditation has been shown to improve resiliency and help people overcome the mental and emotional anguish of traumatic experiences. Several studies examining how meditation helped people with PTSD found it extraordinarily helpful – participants credited the practice with helping them to regain control over their feels and lives, bringing back peace of mind and even enabling them to, once again, experience joy. Best of all? For most people, the benefits are almost immediate!

Question:

Dr. Raj,

A close friend of mine has been seeing the same psychologist every other week for over 4 years.  This friend is college educated and intelligent. He does not abuse drugs or alcohol.  He has a problem with anger management, often reacting out of proportion to events.  His reaction can range from melancholy to temper tantrums that include shouting insults.  He can go up to six weeks without having what I call a “melt down”.  How do I know this?  Because I have actually tracked his mood swings on a calendar over 12 months.  The melt downs can last 2 days, 1 week or he may have one very few days for 2 weeks.  Then, he will recover and appear happy and content for 2 to 6 weeks.  I know this is probably bipolar disorder.  Or maybe it is post traumatic stress, since he grew up with domestic violence between his parents.  The point is…my friend does not appear to be “getting better” in light of all the therapy he has gotten.  I can see no changes in his behavior!over the 3 1/2 months I have known him.  I know my friend speaks openly to his doctor and is honest to a fault.  He does realize he has problems with self esteem, depression, mood swings and handling his anger.  I know not every doctor is the same caliber, too.  What type of therapy should my friend be getting? Talk therapy? Cognitive behavior therapy?  What strategies can you suggest?

Answer:

Dear iNTj,

It does seem that you have a lot of insight into your friends problems and that you genuinely care about his well being.  You mentioned that he see’s a therapist every two weeks, how often is he seeing his psychiatrist?  What is the working diagnoses that his psychiatrist is treating?  Is he on any psychiatric medications and have any helped?

We now know that the most effective treatment will address the Biological-Psychological-Social domains individually.  What this means is that once, the presenting problem is understood, a health care practitioner should address each of these domains to get the most effective treatment response. The Biological domain usually involves medication management, the Psychological involves getting into psychotherapy and the Social domain involves looking at and understanding social factors that are contributing to the persons presenting complaint(s) i.e. family dynamics.

Remember that it takes time to correctly diagnoses and understand the dynamics of human behavior.  I know this can be frustrating for many individuals but the number of diagnostic tests in psychiatry are limited.  Our most useful tool is obtaining a through history from our patients and their families in order to come up with a working diagnoses and over time it is verified or adjusted.  Many times I hear from people, “My Psychiatrist only spent 2 minutes with me, how could he have correctly diagnosed me?”  My response to them is usually to find someone else who will spend the time obtaining the proper history to properly formulate a treatment plan.

As far as therapy goes, I think going every other week is not as effective as going every week.  In my opinion, much happens in two weeks and the session usually becomes about “catching up” versus working on insight.  Their are also many different types of therapy that range from working on supporting the individual to working on insight around internal conflicts.  Their are also therapies that focus on one’s thoughts (Cognitive Behavioral Therapy) as well as being more mindful about one’s behaviors (Dialectic Behavioral Therapy).  Which approach is best is dependent on the individual who is entering it.  As a general rule of thumb those in treatemnt do better than those who are not in treatment.

Thus, I commend your efforts in understanding your friend’s current challenges but remember that he must make the commitment to find the appropriate answers.  You can not do his work for him but only support him along the journey.  He’s lucky to have you in his life.

Question:

Kat writes: My 13 y/o niece was just started on Prozac. She seems to have some anxiety and maybe OCD.  What are your thoughts on young teenagers taking antidepressants?

Answer:

Dear Kat,   Prozac is approved for use in pediatric patients with major depressive disorder (MDD) and obsessive compulsive disorder (OCD).  Selective serotonin reuptake inhibitors (SSRIs) can restore the balance of certain brain chemicals that regulate mood. When these brain chemicals are in proper balance, the symptoms MDD and OCD may be relieved.   Antidepressants are used to relieve the obsessive thoughts and subsequent compulsive behaviors in those who have OCD. By increasing the level of serotonin in the brain, antidepressants help to regulate the communication between different parts of the brain. One thing to keep in mind is that there is the following black box warning with Prozac:    Suicidality in Children and Adolescents— Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Prozac or any other antidepressant in a child or adolescent must balance this risk with the clinical need. With that said, In one 13-week clinical trial in pediatric patients (N=103). Prozac produced a statistically significantly greater mean change from baseline to endpoint than did placebo as measured by the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS).   I suggest that you and your niece work closely with a child psychiatrist in setting up an appropriate treatment plan that may include some therapeutic element.