Presentation By Prof Katya Rubia - The Change Within: Sustainable Effects Ofsustainable Effects Of Meditation On Healthmeditation On Health

The change within: sustainable effects of Meditation on health Katya Rubia [email protected]

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

Benefits

" Relaxation of body & mind

=> Stress relief

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

=> Concentration, reduced background mental noise

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

=> 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

SPECT

fMRI

Yoga Nidra

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

Abstract sense of joy Left frontal, temporal lobe hippocampus N=9

Prefrontal, limbic, anterior cingulate, basal ganglia N=5

Lou et al., 1999

Lazar et al., 2000

Zen Buddhism Thalamus

Concentration on breath R frontal basal ganglia N = 11

Newberg et al., 2001 N = 11

Ritzkes et al., 2003

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

N = 20, 14-60 years.

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

Females

Mishra et al. 2000

Kjaer et al., 2003 Hatha Yoga

! 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

Neuroticism

Depression 10

10

8

8

6

6 4 2 0

8.0

4 2 0

7.8

Difficulties in Diff. in emotion identifying feelings expression

Trait anxiety

Psychoticism 6

45

20

18

5

42

18

16

4

39

16

14

14

12

12

10

10

8

3 2

4.8

4.8 3.2

1

36 33 30

41.7 41.7 35.1 35.1

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

N = 35 20 Meditators 15 Controls

Buddhist insight Meditation: cultivation of mindful attention to present moment

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:

Sahaja Yoga

27 Meditators vs controls during rest

theta & alpha ! enhanced internalised/ decreased externalised attention

Aftanas & Golocheikine 2005

No hemispheric asymmetry over parietal regions (L > R)

Long-term effects on emotional reactivity Sahaja Yoga

Movie clip ‘Stress’

Subjective scores of discrete emotion elicited by movie clip

I

II

III IV V VI VII VIII IX

EEG concomitants of stress (Power difference map)

Emotions: I – disgust, II – happy, III – sadness, IV – anger, V – fear, VI – anxiety, VII – surprise, VIII – joy, IX – contempt.

Autonomic concomitants of stress (Skin potential level reaction difference)

Gamma (30-45!")

#lnP +0.04

1.2 0.9 0.6 0.3

-0.04

Rest

Stress

0

controls meditators

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 General Health

Social F

Mental H

Physical H

1) Meditators score higher on Australian General Health survey.

0

High distress

very high distress

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

pre

7 post

4

*

4 Controls

CBT

Meditation

2 1

25

0

20 pre

15 10

*

5

Controls

CBT

Controls

CBT

Meditation

Depression

post

Meditation

General Mental Health

pre post

3

Anxiety (HAM-D)

0

6 5

2 0

8

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

Sahaja Yoga

parents for 6 weeks. 22.5

25 20

25

** *

5 0

ADHD symptoms

Self-esteem

14.5

20

15 10

22.6

pre post

14.7 pre post

15

*

Parent-child relationship

10 5 0

Unmedicated

Medicated Stopped 16% Reduced 40% Same 45%

Harrison, Manocha, Rubia, 2004

Medication

Epilepsy

Asthma Sahaja Yoga

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

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

! Seizure reduction: 65% after 3months 86% after 6 months ! Reduction of stress-related physiological changes (skin resistance, blood lactate, urinary mandelic acid)

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

! Overall increase in EEG frequency

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

! Improvement of visual acuity and corresponding EEG activity

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.