Meditation and Mindfulness for Anxiety: Evidence by Practice

If you are in crisis or thinking about harming yourself, call, text or chat the 988 Suicide & Crisis Lifeline in the US, free and confidential at any hour. [1] For a life-threatening emergency, call 911. If anxiety is making it hard to work, sleep or leave the house, see a clinician rather than relying on meditation alone.

What this page covers

Anxiety ranges from everyday worry to diagnosed anxiety disorders (such as generalized anxiety, panic and social anxiety). Evidence differs between these groups, and between practices: a full 8-week course, a short stand-alone exercise, or an online program. Labels: established, promising but limited, mixed, insufficient evidence, proper evidence not found.

Evidence by practice and population

The escitalopram trial in detail

In the Treatments for Anxiety: Meditation and Escitalopram (TAME) trial, 276 adults with a diagnosed anxiety disorder were assigned to 8 weeks of weekly MBSR classes or escitalopram, an antidepressant used for anxiety. A blinded interviewer rated anxiety severity. Scores fell by 1.35 points with MBSR and 1.43 with escitalopram, within the preset margin for "not worse." [2] Study-related side effects were reported by 15.4% of the MBSR group and 78.6% of the medicine group, and no one stopped MBSR because of side effects. [2] Limits: people knew which treatment they had, 208 of 276 finished, and the trial had no waitlist or placebo group. The abstract I read did not state who funded it.

A follow-up phase moved both treatments online. MBSR over video matched in-person MBSR, but social anxiety symptoms improved more with in-person care, and escitalopram had a greater effect on panic symptoms than video MBSR. [3]

Other reviews, and what they leave open

A 2018 review of 142 samples across psychiatric disorders named depression, pain conditions, smoking and addictive disorders as having the most consistent evidence, which means anxiety is less settled. [8] A review for clinicians concluded there was not enough data to recommend mind-body methods as primary treatment for anxiety disorders, though they may be considered within a larger plan because risk is low. [9]

Social anxiety and panic: Proper evidence not found in a dedicated review I could read. I searched PubMed for reviews of mindfulness for social anxiety and for panic and found no systematic review to read here. The only data above come from subgroups of the TAME follow-up. For panic specifically, see panic, anxiety and dissociation during meditation.

Practical next steps

Many people start with a short guided practice or a taught course. See MBSR in detail, mindfulness compared with CBT and ACT and meditation compared with medication and therapy. For slow-breathing options see breathing exercises for stress, and for care options see therapy for anxiety and stress.