The change within: sustainable effects of Meditation on health

Katya Rubia
k.rubia@iop.kcl.ac.uk

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)

Subjective Effects " Relaxation of body & mind " Pure consciousness, att. focus/ alertness/perceptual clarity " Positive emotions " Feelings of serenity, joy, bliss " Emotional detachment " Feelings of compassion

Benefits => Stress relief => Concentration, reduced background mental noise => Mood stability => Emotional resilience => Social consciousness

Objective 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 neurobiological correlates of the state of Meditation?

Neurobiology of Meditation State
Physiology
! 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

Neurophysiology
! 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

EEG correlates of thoughtless awareness
Connectivity
Sahaja Yoga

N = 27
Happiness Thoughts

Chaotic Complexity

1) 2)

Enhanced theta activity and coherence over fronto-parietal ( internalised attention) & left frontal regions (positive emotions). Enhanced alpha ( externalised attention) Reduced overall complexity (less chaos)
Aftanas & Golocheikine, 2001, 2002, 2003

Modern neuroimaging studies
PET
Yoga Nidra Abstract sense of joy Left frontal, temporal lobe hippocampus N=9 Prefrontal, limbic, anterior cingulate, basal ganglia
N=5

fMRI

SPECT

Buddhist Mantra Meditation Kundalini Yoga Concentration on breath/mantra Concentration on mantra

Lou et al., 1999 Zen Buddhism

Lazar et al., 2000 Thalamus

Concentration on breath
R frontal basal ganglia N = 11 Ritzkes et al., 2003

Newberg et al., 2001 N = 11

Neurochemical changes
Increase in Beta-endorphin levels in blood
Sahaja Yoga

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

Theta

200 150 100 50 0

*

Rest Meditation
Males Females

Dopamine increase (~65%) correlated with meditation-induced EEG changes Kjaer et al., 2003 Hatha Yoga

N = 20, 14-60 years.

Mishra et al. 2000

! Increase in Melatonin => sleep, pos emotions, immune s. ! Increase in Serotonin => positive emotions ! Decrease in Cortisol => Stress ! Decrease in Noradrenaline (arousal)
Harinath et al., 2000

Conclusions on neurobiological effects

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

What are the sustainable long-term trait effects?
Do the state changes become trait changes with long-term practice?

Long-term effects on personality
CONTROLS MEDITATORS Sahaja Yoga

Depression 10 8 6 4 2 0 10 8 6 4 2 0

Neuroticism 6 5 4

Psychoticism 45 42 39

Trait anxiety 20 18 16

Difficulties in Diff. in emotion identifying feelings expression 18 16 14 12 10 8

8.0

7.8

3 2 1

4.8

4.8 3.2

36 33 30

41.7 41.7 35.1 35.1

14 12 10

Aftanas & Golocheikine, 2005

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

Long-term effects on physiology
! Reduced activation of autonomic system ! Reduced endocrine response (cortisol) ! Enhanced immune response ! Enhanced melatonin & serotonin

Long-term effects on brain structure
Greater cortical thickness in Meditators compared to Non-Meditators
Buddhist insight Meditation: cultivation of mindful attention to present moment

N = 35 20 Meditators 15 Controls

Right prefrontal cortex (sustained attention)

Insula (interoceptive perception) Meditation slows age-related thinning of prefrontal lobe => Meditation-dependent cortical plasticity.
Lazar et al., NeuroReport, 2005

Long-term effects on rest brain function
Baseline EEG:
27 Meditators vs controls during rest
Sahaja Yoga

theta & alpha ! enhanced internalised/ decreased externalised attention

No hemispheric asymmetry over parietal regions (L > R)

Aftanas & Golocheikine 2005

Long-term effects on emotional reactivity
Movie clip ‘Stress’

Sahaja Yoga
Subjective scores of discrete emotion elicited by movie clip
Emotions: I – disgust, II – happy, III – sadness, IV – anger, V – fear, VI – anxiety, VII – surprise, VIII – joy, IX – contempt.

I

II

III IV V VI VII VIII IX

EEG concomitants of stress (Power difference map)
Gamma (30-45!") #lnP +0.04

Autonomic concomitants of stress (Skin potential level reaction difference)

1.2 0.9 0.6 0.3

-0.04

0

controls meditators

Rest

Stress

Aftanas & Golocheikine 2005

Long-term effects on general health
Survey in 350 Sahaja Yoga Meditators in Australia
Norm
90 80 70 60 50 40 30 20 10 0
Sahaja Yoga

Meditators

*

*

*

*
10 8 6 4 2

* *
High distress very high distress

General Health

Social F

Mental H

Physical H

0

1) Meditators score higher on Australian General Health survey.

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

3) Frequency & depth of thoughtless awareness correlated with scores

Manocha et al., 2007

Conclusions on long-term effects

Meditation appears to have long-term effects on
! Personality ! Cognitive functions ! Brain structure & function ! Biochemistry ! General & mental health

What is the clinical application of Meditation?
#

Neuropsychiatric disorders

Depression
#

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.

Depression
# #

Study design: 24 patients with depression, 27-53 yrs. 3 groups: Sahaja Yoga Meditation, CBT, Control. 6 weeks.
Sahaja Yoga
14 12 10 8 6 4 2 0 Controls CBT Meditation

*

pre

8 7 6 5 4 3 2 1 0 Controls CBT Meditation

post

*

pre post

Anxiety (HAM-D)

25 20 15 10 5 0 pre

Depression

*
Controls CBT Meditation

post

General Mental Health

Morgan et al. 2000

Attention Deficit Hyperactivity 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 behaviour
#

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

Sahaja Yoga

22.5

25 20 15 10 5 0
ADHD symptoms Self-esteem

22.6 14.5 14.7 pre post

** *
pre post

25 20 15

*

10 5 0
Unmedicated Medicated
Stopped 16% Reduced 40% Same 45%

Parent-child relationship

Medication

Harrison, Manocha, Rubia, 2004

Epilepsy
Sahaja Yoga

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

! Sahaja Yoga and sham intervention on
patients with epilepsy for 6 months ! Seizure reduction: 65% after 3months 86% 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

! Reduction of severity of asthma (air-way hyper-reactivity) ! Increase of subjective ratings of asthma-related quality of life

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

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

Overview on clinical effects
Meditation has shown positive effects on a range of disorders
# # # # # # # # #

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

Overall conclusions
• 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.