Participants learn to handle daily stresses and gain more control through yoga, breathing, body scans.

African-American women with lower socio-economic status have an increased risk of depressive disorders, yet they rarely seek out antidepressants or psychotherapy because of negative attitudes and stigma associated with conventional mental health treatments.

A new pilot Northwestern Medicine study showed that eight weeks of mindfulness training helped alleviate their depressive symptoms and reduce stress, providing an effective alternative to more conventional treatment.

"Many women are in need of help with their depression and coping with daily life, but they don't seek it out because of limited access to high-quality mental health services and the stigma within their families and communities," said the study's principal investigator Inger Burnett-Zeigler, assistant professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. "Our study shows that there are alternatives to traditional mental health treatment, such as mind-body approaches, that effectively alleviate symptoms and can be done autonomously in the comfort of their own home."

Over the course of the 16-week study, the average depressive symptoms and stress scores decreased across the 31 participants. They also reported an increase in well-being and were able to recognize stressful triggers in their lives, notice how their bodies react to triggers and learn how to gain more control over their physiological responses to stress.

"It felt good to be in control of my emotions for the first time in my life," one participant said. Another said, "We are always superwomen [and] we have to be able to do everything, and that brings out a lot of stress. ...This helped me to reorganize and put [these stressful events] in the proper perspective and understand I have an opportunity to learn how to calm myself down and recognize what is going on."

The study, which was published in Complementary Therapies in Clinical Practice, is the first to examine the effectiveness of mindfulness-based interventions to combat depression among disadvantaged women in a Federally Qualified Health Center (FQHC), which provides comprehensive community-based medical care to low-income individuals.

Burnett-Zeigler and her co-authors recruited women from the Komed Holman Health Center, an FQHC on Chicago's South Side. At the time of recruitment, 91 percent of the women at the center were eligible for the study, which demonstrates the high level of mental health need among adult women in the FQHC. Thirty-one women ended up participating in the study.

Burnett-Zeigler said there is great potential to expand mindfulness-based interventions nationally based on this growing need to provide low-cost, effective mental health services in community-based settings. Her future studies aim to examine the feasibility of national implementation and dissemination.

The mindfulness techniques Burnett-Zeigler teaches include sitting meditation, yoga, mental body scans and taking a mindful pause to be in the moment. Patients are encouraged to increase their awareness of everyday activities, such as taking a shower or drinking a cup of coffee.

"These practices help them take a step back and live in the moment versus worrying about what's already happened or what's to come," Burnett-Zeigler said. "People who are depressed or who have depressive symptoms often have tunnel vision, whereby they're only seeing information in the environment that supports their negative beliefs."

Study participants also were encouraged to engage in daily practice at home, in addition to the guided sessions in the clinic. On average, participants practiced meditation, yoga and mental body scans four days per week and spent an average of 2.5 hours practicing a week.

Before participating in the study, 45 percent of the women reported no prior experience with meditation, and 71 percent reported no past experience with yoga. All of the women who participated in the study reported symptoms of depression, however 87 percent had not received any mental health treatment in the past year.

This study was supported by grant AHRQ K12HS023011 from the Agency for Healthcare Research and Quality.

Article: Mindfulness based stress reduction adapted for depressed disadvantaged women in an urban Federally Qualified Health Center, Inger Burnett-Zeigler, Maureen D. Satyshur, Sunghyun Hong, Amy Yang, Judith Moskowitz, Katherine L. Wisner, Complementary Therapies in Clinical Practice, doi: 10.1016/j.ctcp.2016.08.007, published online 13 August 2016.