Meditation for Depression
Meditation for Depression
Major Depressive Disorder (MDD) is a serious, costly and highly prevalent condition. However,
 currently available treatment options have limited efficacy. The aim of this pilot study is
 to determine whether patients suffering from MDD who have not responded to at least one
 antidepressant trial may actively engage in a novel group therapy, Central Meditation and
 Imagery Therapy (CMIT). Preliminary results with individual patients suggest that CMIT
 techniques may have benefit for major depression. The purpose of this trial is to assess the
 feasibility of a group form of CMIT for the treatment of major depression. The trial will
 also seek to identify neurophysiological and cardiovascular predictors of treatment response.

 In this study, 10 subjects with major depressive disorder will receive antidepressant
 treatment augmentation with group meditation and mental imagery therapy for a total of 12
 weeks, as well as daily meditation practice. Group sessions will also involve gentle yogic
 stretches. The subjects will be limited to those who remain depressed despite at least one
 trial of antidepressant medication. Changes in brain activity and heart rate variability will
 be measured at three time points utilizing electroencephalography (EEG) and pulse monitors.
 Depression symptoms will be measured at several time points using questionnaires and
 objective measures. Participation will require a total of 15 visits for weekly therapy and
 the measurements. Two-month follow-up questionnaires will be mailed to the subjects after
 study end to assess durability of any improvements in depressive symptoms.
Inclusion Criteria:

 -  Meeting the DSM-IV criteria for unipolar major depressive disorder, as assessed by the
 Mini-Neuropsychiatric International Interview (MINI).

 -  HAM-D17 rating scale ≥ 14.

 -  Prior treatment with antidepressant medication during the present major depressive
 episode

 -  Adequate written and oral fluency in English to understand and complete study forms
 and converse with study personnel.

 -  Willingness on part of both subject and treating clinician to not change
 antidepressant treatment, including medications, psychotherapy or other treatments,
 over the course of the study, unless necessary to provide for well being of subject.

 Exclusion Criteria:

 -  Current diagnosis of schizophrenia or any psychotic disorder including psychotic
 depression, dysthymia, mania or bipolar disorder, attention deficit or hyperactivity
 disorder, generalized anxiety disorder or panic disorder, obsessive compulsive
 disorder, alcohol or drug dependence, mental retardation, any pervasive developmental
 disorder or cognitive disorder (according to DSM-IV) criteria. Those with lifetime
 history of psychiatric conditions other than unipolar major depression will be also
 excluded.

 -  Medically unstable, delirious, or terminally ill (e.g. medical illness requiring
 hospitalization or intense outpatient management, such as heart disease; heart attack
 in the past 6 months; congestive heart failure; severe heart arrythmias; unstable
 hypertension; poorly controlled diabetes; or pending surgery).

 -  Past history of skull fracture; cranial surgery entering the calvarium; space
 occupying intracranial lesion; stroke/ aneurysm; Parkinson's or Huntington's disease;
 or Multiple Sclerosis.

 -  Participants regularly practicing (≥ 2 times per week) any of the techniques utilized
 in the study to reduce stress: meditation, guided imagery, yoga.

 -  Current treatment with behavior therapy or psychotherapy.

 -  Active suicidal plan as measured by HAM-D item 3 score of greater than or equal to 3,
 or history of suicide attempt during the current episode.

 -  Utilization of cannabis or other illicit drugs more than once a month.

 -  Excessive use of alcohol, i.e., men whose alcohol consumption exceeds 14 standard
 drinks per week or 4 drinks per day, and women whose alcohol consumption exceeds 7
 standard drinks per week or 3 drinks per day.

 -  Needing to adjust or change anti-depressant treatment, including medications,
 psychotherapy, repetitive Transcranial Magnetic Stimulation (rTMS), Electroconvulsive
 Therapy (ECT), or Vagus Nerve Stimulation (VNS).