Walking as a treatment for depression is a good idea. Reports vary, but most suggest that there is a small, positive effect from encouraging people to exercise.[i]
I have seen patients who had a large and reliable response to walking therapy for depression. I ask people to simply scale their depression from zero to ten, where zero equals the worst they have ever felt, and ten is the best.
Most people will rate their depression at “3” on this scale, and that translates on the Center for Epidemiological Studies – Depression (CES-D) scale as “moderate depression,” scoring between 18 and 26. Beck Depression Inventory scores are essentially equal to the CES-D.
Now comes a study from Thailand comparing Buddhist Walking Meditation (BWM) with Traditional Walking Exercise (TWE) and with a control group. The whole study is available online at the Journal of Alternative and Complimentary Medicine site.[ii]
(Let us pause and offer thanks to the Journal of Alternative and Complimentary Medicine since most journals are greedy and selfish and want to charge us $30 or so for a download of an article. Kudos to JACM and shame on all the other publishers.)
The subjects were elderly female Thai scoring in the moderately depressed range on a geriatric depression measure. The actual exercise was as follows, from the article:
“Both TWE and BWM exercise programs were divided into two phases. In phase 1 (weeks 1–6), TWE and BWM training programs were conducted at mild intensity (20%–39% individually determined heart rate reserve) performed for 20 minutes, 3 times a week. In phase 2 (weeks 7–12), the training intensity was increased to moderate intensity (40%–50% heart rate reserve) performed for 30 minutes, 3 times a week. Both exercise programs were closely supervised by one of the investigators. Adherence to the prescribed exercise intensity was confirmed using heart rate monitors (Polar Team 2 Pro, USA). Both TWE and BWM programs also included 11 common stretching exercises performed during warm-up and cool-down stages. All of the exercise training involved walking on the 50-m oval-shaped indoor track.”
The walking meditation consisted of swinging both arms forward on the in-breath while thinking of the sound “Budd” and swinging the arms back on the out-breath, thinking of the sound “Dha.” Thus, the person meditated on the term “Buddha” as they walked.
While both of the active groups improved in fitness, only the BWM group improved in mental health. Talk a look at this chart:
This is a surprise to me because generally you would expect to see more improvement in the TWE as well as the meditation walking group. Why didn’t this exercise show that?
Yet, we have known for a long time that meditation has a positive effect on depression.[iii] So that part is not a surprise.
So thinking about the results, we have to wonder about the participants. Buddhism is respected and widely practiced in Thailand, so the acceptance factor should be very large with this group. How would you apply such a practice to Europeans or Americans?
Several ideas come to mind.
First, mindfulness is less explicitly aligned with Buddhism than the Budd-Dha prayer in this program. So one could do the same study by focusing on savoring as a skill (alignment to the current moment, dropping thoughts of the past or future). This promotes a mindful quality that isn’t so aligned with the religion.
Second, one could combine mindful walking meditation with a religiously appropriate prayer. If a person is Christian, some form of the Jesus prayer, or for a Jewish subject, the “Hear, oh Israel, G-d is one” prayer.
Third, any counselor can learn this, and if one does learn it, one can teach it. Try it and see. Use a reliable depression rating scale each session and see if you are having a positive impact. The CES-D is widely available and easy to use.
So I tried mindful walking meditation. As I practiced, I found my mind wandering shamelessly. I started thinking of how I could write this blog, I thought of how much time I needed to do this, I thought of all kinds of irrelevant ideas.
I practiced accepting and releasing. I would shift my awareness to “thinking, thinking . . .” and focus back on the feelings of walking and breathing.
When my mind wanders, I notice the wandering by observing that I am thinking, and I comment, “thinking, thinking, that’s just thinking . . .” The essence of savoring / mindful open meditation is to simply be aware of the sights, sounds, tastes, touch, and smell in my current experience.
I walk mindfully and then my mind wanders. I reorient it back to the moment, and enjoy the awareness of my feet and my breath and my arms swinging and the sights and sounds . . . and my mind wanders again. I practice it over and over. After about twenty minutes, my lunch hour was over and I went back to work.
It was a pleasant experience.
I might try it again some day.
_________________
[i] Rimer J, Dwan K, Lawlor DA, Greig CA, McMurdo M, Morley W, Mead GE. Exercise for depression. Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No.: CD004366. DOI: 10.1002/14651858.CD004366.pub5. [ii]http://online.liebertpub.com/doi/full/10.1089/acm.2013.0205 [iii]http://www.openground.com.au/articles/Shapiro%20Schwartz%20Bonner%201998.doc.pdf
9 Responses
Duccio Manfredi
Hello Dr.J
I have enjoyed reading your post and I am glad that you had a pleasant experience. I practice walking meditation every day and I love it!. I have written a post about walking meditation and my experience, hope you don’t mind me sharing it here with you. http://howtobehappy.guru/what-is-walking-meditation/
Thank you.
Wish you a Happy Day!
Kidbux
Thanks sharing. Walking meditation not only help us be mindful all day while also increase our wisdom. Recently, I met a guru who practice for over 30years, he is Venerable Vimokkha and did share his teaching in MP3 files in my blog. Feel free download this free meditation teaching in MP3 at:
http://www.kidbuxblog.com/ajahn-wimoak
David B. Adams, Ph.d.
Hey Lynn!! Thanks for the referral, I have been semi-retired for the past 15 years, but I am continuing a part- time practice. Currently, my emphasis is treatment of children & teenagers, but also evaluations for refugees seeking disability exemptions for citizenship qualification (N-648 evals. Good to hear that you’re still practicing! Are you accepting new patients??
Dr.J
New patients? Only those who don’t need to use insurance!
Thanks, Lynn
Zak Zaklad
As you know, i am a Tai Chi enthusiast. when one becomes comfortable in the movements of Tai Chi form, then we work on becoming “moving meditators” with the mental benefits of meditation plus the health benefits of the Tai Chi exercise.
Dr.J
Zak is right, Tai Chi has similar benefits. I personally believe the same time practicing Tai Chi would give the same results as this study. Another opportunity for some grad student to make a name and provide some real benefit to the mental health community!
Lynn
Dr.J
Marla is right, the swinging arms together seems very odd, and perhaps I misread the article, but that is how it was described. The arms swing up, the breath goes in, and one thinks “Budd” and then the arms swing down and the breath goes out and one thinks “Dha”. I thought it was odd so when I did my walking meditation, I did an open focus discipline.
Judy Krings
Lovely, Lynn, and I going to try this, too! Many thanks.
Marla
Do you really swing both arms forward and then both arms backward? That seems very unnatural to
me when walking.