The change within: The change within: sustainable effects of sustainable effects of Meditation on healthMeditation on health

k.rubia@iop.kcl.ac.uk

KatyaKatya RubiaRubia

What is Meditation?What is Meditation?! Meditation is a hypometabolic state that elicits physical & mental

calm through the reduction/elimination of thoughts.Thoughtless Awareness = state of higher (“pure”) consciousness (Nirvichara Samadhi; 4th state of consciousness)

" Relaxation of body & mind

" Pure consciousness, att. focus/alertness/perceptual clarity

" Positive emotions" Feelings of serenity, joy, bliss" Emotional detachment " Feelings of compassion

=> Stress relief

=> Concentration, reduced background mental noise

=> Mood stability=> Emotional resilience=> Social consciousness

Subjective EffectsSubjective Effects BenefitsBenefits

Objective effects of MeditationObjective effects of Meditation

Neurobiological correlates of the “state” of Meditation

Evidence for long-term sustainable “trait” effects

Clinical application: effects of Meditation on illness

What are the What are the neurobiological correlates of the neurobiological correlates of the

statestate of Meditation?of Meditation?

Neurobiology of Meditation StateNeurobiology of Meditation State

! Increased parasympathetic, reduced sympathetic activity! Changes in physiological parameters that indicate stress relief

! Decreased heart, respiratory, pulse rates, blood pressure, oxygen metabol.! Reduced cortisol (stress), noradrenaline (arousal)! Increase in immune response

Subjective: Feelings of deep calmness & relaxation

! Activation of fronto-parietal neuronetworks of internalised attention

Subjective: thought elimination, attentional focus, altered consciousness

! Activation of the fronto-limbic emotional neuronetworks! Increased activation in limbic brain regions & left frontal lobe! Release of neurochemicals that enhance positive emotions

(beta-endorphines, dopamine, melatonin and serotonin).

Subjective: feelings of joy, feeling of benevolence/compassion

PhysiologyPhysiology

NeurophysiologyNeurophysiology

N = 27

Aftanas & Golocheikine, 2001, 2002, 2003

1) Enhanced theta activity and coherence over fronto-parietal ( internalised attention)& left frontal regions (positive emotions). Enhanced alpha ( externalised attention)

2) Reduced overall complexity (less chaos)

Happiness Thoughts

Sahaja YogaSahaja Yoga

EEG correlates of thoughtless awarenessEEG correlates of thoughtless awareness

Connectivity

ChaoticComplexity

PET

Lou et al., 1999

Left frontal, temporal lobehippocampusN = 9

SPECT

Newberg et al., 2001

Thalamus

Buddhist Mantra MeditationYoga Yoga NidraNidra

Zen Buddhism

R frontalbasal ganglia

Ritzkes et al., 2003

fMRI

Abstract sense of joy

Concentration on breath

Concentration on mantra

N = 11

Kundalini YogaConcentration on breath/mantra

Lazar et al., 2000

Prefrontal, limbic, anterior cingulate,basal ganglia

Modern Modern neuroimagingneuroimaging studiesstudies

N = 5

N = 11

Dopamine increase (~65%) correlated with meditation-induced EEG changes

Kjaer et al., 2003

Increase in Dopamine release (~ 65%) in limbic area (ventral striatum)

0

50

100

150

200

Males Females

RestMeditation

N = 20, 14-60 years.

Increase in Beta-endorphin levels in blood

Mishra et al. 2000

*

ThetaYoga Yoga NidraNidraSahaja YogaSahaja Yoga

! Increase in Melatonin => sleep, pos emotions, immune s.! Increase in Serotonin => positive emotions! Decrease in Cortisol => Stress! Decrease in Noradrenaline (arousal)

HathaHatha YogaYoga

Harinath et al., 2000

NeurochemicalNeurochemical changeschanges

Meditation techniques differ, but the most consistent findings are

! Activation of fronto-parietal neural networks related to sustained internalised attention

! Activation of limbic and left frontal brain areas in relation to positive emotions

! Biochemical changes suggestive of positive affect

Conclusions on neurobiological effectsConclusions on neurobiological effects

What are the sustainable What are the sustainable longlong--term term traittrait effects?effects?

Do the state changes become trait changes with long-term practice?

CONTROLSCONTROLS

MEDITATORSMEDITATORS

8.0

Difficulties in identifying feelings

Diff. in emotion expression

7.8 4.8

0246810

Depression

0246810

Neuroticism Psychoticism

4.83.2 35.1

41.7

Trait anxiety

35.141.7

303336394245

123456

101214161820

81012141618

LongLong--term effects on personalityterm effects on personality

LongLong--term effects on cognitionterm effects on cognition! Perceptual processing (acuity)! Sustained attention! Motor & cognitive inhibitory control! Faster executive functions

LongLong--term effects on physiologyterm effects on physiology

! Reduced activation of autonomic system! Reduced endocrine response (cortisol)! Enhanced immune response! Enhanced melatonin & serotonin

Sahaja YogaSahaja Yoga

Aftanas & Golocheikine, 2005

LongLong--term effects on brain structureterm effects on brain structure

Lazar et al., NeuroReport, 2005

Greater cortical thickness in Meditators compared to Non-Meditators

Right prefrontal cortex(sustained attention)

Insula (interoceptive perception)

Meditation slows age-related thinning of prefrontal lobe => Meditation-dependent cortical plasticity.

N = 35 20 Meditators15 Controls

Buddhist insight Buddhist insight Meditation: cultivation Meditation: cultivation of mindful attention to of mindful attention to

present momentpresent moment

LongLong--term effects on rest brain functionterm effects on rest brain function

Aftanas & Golocheikine 2005

27 Meditators vscontrols during rest

theta & alpha! enhanced internalised/decreased externalised attention

Baseline EEG: Sahaja YogaSahaja Yoga

No hemispheric asymmetry over parietal regions(L > R)

Gamma (30-45!")

+0.04

-0.04

#lnP

EEG concomitants of stress (Power difference map)

I II III IV V VI VII VIII IX

Emotions: I – disgust, II – happy,

III – sadness, IV – anger,

V – fear,VI – anxiety,

VII – surprise, VIII – joy,

IX – contempt.

Subjective scores of discrete emotionelicited by movie clip

Autonomic concomitants of stress (Skin potential level reaction difference)

Movie clip ‘Stress’Movie clip ‘Stress’

LongLong--term effects on emotional reactivityterm effects on emotional reactivity

Rest Stress

0

0.3

0.6

0.9

1.2

meditatorscontrols

Sahaja YogaSahaja Yoga

Aftanas & Golocheikine 2005

LongLong--term effects on general healthterm effects on general health

0102030405060708090

GeneralHealth

Social F Mental H Physical H

Survey in 350 Sahaja Yoga Meditators in Australia

0

2

4

6

8

10

High distress very high distress

Norm Meditators

Manocha et al., 2007

**

****

2) Meditators score lower on measures of morbidity (Psychological Distress).

1) Meditators score higher on Australian General Health survey.

3) Frequency & depth of thoughtless awareness correlated with scores

Sahaja YogaSahaja Yoga

Meditation appears to have long-term effects on

! Personality

! Cognitive functions

! Brain structure & function

! Biochemistry

! General & mental health

Conclusions on longConclusions on long--term effectsterm effects

What is the clinical What is the clinical application of Meditation?application of Meditation?

# Neuropsychiatric disorders

# In 2020 depression is estimated to be the 2nd leading cause of disability worldwide (WHO).

# 90% of patients with remittent depression have somatic symptoms. 75% of these relapse after treatment.

# Suicide = 3rd leading cause for death worldwide.

# Teenage depression is escalating. Medication problematic in teenagers.

# Why Meditation? • Decreases anxiety & stress-related physiol. measures

– decreases cortisol levels (stress)

• Stabilisation of mood (enhances networks of positive emotions and “happy” neurochemicals (beta-endorphines, DA & SE))

• thought reduction counteracts rumination.

DepressionDepression

# Study design: 24 patients with depression, 27-53 yrs.# 3 groups: Sahaja Yoga Meditation, CBT, Control. 6 weeks.

0

2

4

6

8

10

12

14

Controls CBT Meditation

pre

post

*

Morgan et al. 2000

012345678

Controls CBT Meditation

pre

post

0

5

10

15

20

25

Controls CBT Meditation

pre

post

Anxiety (HAM-D)

Depression

*

*

General Mental Health

DepressionDepression

Sahaja YogaSahaja Yoga

Attention Deficit Hyperactivity Attention Deficit Hyperactivity

Disorder (ADHD)Disorder (ADHD)

# ADHD is a disorder of inattention, impulsivity, and hyperactivity: poor self-control & poor attention focus

# Stimulant treatment of ADHD: unknown effects on developing brain, side-effects

# Why Meditation? • inner calm & relaxation ($hyperactivity)• self-control ($ impulsivity)• focussed internalised attention ($ inattention).• enhances fronto-parietal brain regions that are under-functioning

in ADHD

Effects on ADHD behaviourEffects on ADHD behaviour

# Study design: 26 children with ADHD, 4-12 yrs, twice weekly Meditation with parents for 6 weeks.

0

5

10

15

20

25

ADHD symptoms Self-esteem Parent-childrelationship

prepost

Harrison, Manocha, Rubia, 2004

22.5

14.5

22.6

14.7

0

5

10

15

20

25

Unmedicated Medicated

prepost

Sahaja YogaSahaja Yoga

**

* *

Stopped16%

Reduced40%

Same45%

Medication

AsthmaAsthma

Manocha et al., 2000Chugh et al., 1997

EpilepsyEpilepsy

! Sahaja Yoga and sham intervention on patients with epilepsy for 6 months

! Seizure reduction: 65% after 3months86% after 6 months

! Reduction of stress-related physiological changes (skin resistance, blood lactate, urinary mandelic acid)

! Overall increase in EEG frequency

! Improvement of visual acuity and corresponding EEG activity

Panjwani et al., 1995, 1996, 2000Gupta et al., 1997

! 30 Patients with Asthma (Sahaja Yoga) compared to 25 control patients (relaxation)

! Reduction of severity of asthma (air-way hyper-reactivity)

! Increase of subjective ratings of asthma-related quality of life

Sahaja YogaSahaja Yoga

Overview on clinical effectsOverview on clinical effects

# Depression & Anxiety (Sahaja Yoga, Mindful Meditation)

# Obsessive-compulsive disorder (Kundalini Yoga)

# ADHD (Sahaja Yoga)

# Epilepsy (Sahaja Yoga)

# Asthma (Sahaja Yoga, Pranayama)

# Menopause & PMS (Sahaja Yoga, Relaxation response)

# Drug abuse (Sahaja Yoga, Hatha Yoga)

# Occupational stress (Sahaja Yoga)

# Migraine

Meditation has shown positive effects on a range of disorders

• Meditation has short- & long-term effects on general & mental health, on personality and on cognition & affect.

• These changes appear to be mediated by measurable long-term plastic changes in underlying body & brain physiology & neurochemistry.

• Preliminary clinical applications show a positive effect of Meditation on a wide range of disorders

• Meditation has potential to play a prominent role in achieving sustainable global health.

Overall conclusionsOverall conclusions