You may have seen in the news media this week that new research suggests antidepressant drugs may damage men's sperm and increase the risk of infertility. Researchers from Cornell Medical Center in New York found that some men given the common SSRI antidepressant paroxetine (Paxil, Seroxat) for four weeks had far higher levels of sperm with damaged DNA. Experts say this does not necessarily mean these men would have more trouble becoming fathers but that it was certainly a cause for concern.

So here we have another reason to look for alternatives to the antidepressant drugs which are prescribed to many millions of people every year. Earlier this year it was revealed that drug companies had buried studies showing that these drugs are largely ineffective in all but the most severe cases of depression. Before that paroxetine was linked to an increased risk of suicide.

In a previous blog I have talked about nutritional and herbal supplements that can help to combat depression. This week I'd like to talk about a therapy known as mindfulness-based cognitive behavioural therapy (MCBT) which may be an effective alternative to antidepressants for depression and anxiety and may also help those with chronic fatigue syndrome (ME/CFS), fibromyalgia and environmental illness. MCBT is a combination of minfulness meditation, a technique derived from Buddhist and Hindu traditions, and cognitive behavioural therapy (CBT).

Cognitive Behavioural Therapy (CBT)

CBT is a therapy which aims to identify negative thoughts, assumptions, and beliefs and highlight how they are related to negative emotions and ultimately actions and behaviours which only serve to worsen a person's mood and/or medical condition. Once this has been accomplished CBT aims through various methods to replace these with more, realistic, positive and beneficial thoughts and behaviours.

Techniques employed in CBT include keeping a diary of significant events and associated thoughts, feelings and behaviours; questioning those which may be unhelpful and unrealistic; trying out new ways of reacting to these situations; and gradually facing situations and activities that may have been avoided in the past.

I have had a course of CBT myself after being referred from a psychiatrist whom I was seeing about my health problems which included depression, anxiety, ME/CFS and irritable bowel syndrome. CBT is commonly used for these conditions. The use of CBT for ME/CFS is controversial because although a few studies have found it to be helpful when patients are surveyed it generally gets a resounding thumbs down verdict. I have to say I would also rate it this way. Don't get me wrong, the theory behind CBT all makes a lot of sense and I found it both interesting and enligtening looking at how my thoughts, beliefs, and emotions all influenced the way I behave. The problem is that I found CBT gave me little in the way of tools to implement lasting changes based on what I discovered about myself.

Mindfulness-Based Cognitive Behavioural Therapy (MCBT)

I was left to myself to discover the tools I felt were missing in CBT and I did....in the form of meditation. After beginning the practice of regular meditation I found that it quickly had profound effects on my mood, self-esteem and self-believe, motivation, and general cognitive abilities; all of which helped me to make positive changes in my life and implement the changes identified in my CBT sessions.

I am clearly not the only one who has found this combination of meditation and CBT to be effective as mindfulness-based cognitive behavioural therapy is increasingly being offered to patients.

MCBT is based on the work of Dr Jon Kabat-Zinn, a researcher who specialised in the mind-body interaction, and had been practising mindfulness meditation as part of Zen Buddhism for many years. Building on Kabat-Zinn's work MCBT was further developed by Zindel Segal, Mark Williams and John Teasdale. The therapy has proven very effective for depression in clinical studies and is now endorsed by the UK's National Institute for Health and Clinical Excellence (NICE).

Mindfulness meditation teaches us how to focus on the present moment and act with purpose rather than letting judgements about past events or fears about what may happen in the future affect how we feel right now. Being focused only on the present in this way helps us to respond positively to situations rather than react in a negative way. As a result the use of mindfulness may better prepare people to implement the changes in thought and behaviour indentified by the traditional CBT part of the therapy.

From my personal experience I would certainly recommend that anyone suffering from depression/anxiety or chronic illnesses such as ME/CFS and fibromyalgia if offered CBT should instead ask that they be referred to a therapist who uses MCBT instead, or seek one out yourself. Together meditation and CBT can be a powerful tool where CBT alone often falls down.

Learn more about MBCT:

The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness

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