Transcendental meditation reduces burnout, depression among physicians

Academic physicians suffering from burnout and depression reported significant improvements after participating in an intervention that promoted the practice of transcendental meditation, a recent study found.

Marie Loiselle, PhD, an assistant professor at Maharishi International University in Iowa, and colleagues wrote in the Journal of Continuing Education in the Health Professions that while academic physicians have shown to be less vulnerable to burnout than those in nonacademic settings, “life stressors” such as disaffection and a lack of engagement can still contribute to depression and anxiety among this group.

The researchers conducted a mixed methods randomized controlled trial to analyze the effectiveness of transcendental meditation (TM), a technique chosen for its easy practice and prior effectiveness in addressing burnout, among 40 academic physicians at a medical school and affiliated Veterans Affairs hospital.

According to Loiselle and colleagues, TM differs from other meditation techniques “both in procedure and results.” It is classified in the “automatic self-transcending category of meditation practices” and requires neither contemplation nor concentration.

“It is practiced for 20 minutes twice daily while sitting comfortably with eyes closed. Without controlling mental activity, TM uses a simple mental procedure that allows the mind to naturally settle down to progressively finer more alert levels of thought,” they wrote. “As the mind spontaneously becomes less active, the body correspondingly settles to a deep state of rest. This state, known as restful alertness, promotes mind and body flexibility without involving any belief or change in one’s lifestyle.”

Of the participants, 21 were randomly assigned to TM and 19 were assigned to no treatment. The researchers used various scales to measure physicians’ levels of burnout, depression, insomnia, perceived stress and resilience at baseline, 1 month and 4 months. They also conducted qualitative interviews at baseline and 4 months.

At 1 month and 4 months, significant improvements were found for total burnout (P = .02), emotional exhaustion (P = .042), personal accomplishment (P = .018) and depression (P = .016) in the TM group compared with the control group.

“One-month findings showed the experimental group having larger decreases than the control group for total burnout, [emotional exhaustion], depression, insomnia, and perceived stress and a larger increase in resilience,” Loiselle and colleagues wrote.

However, the differences in perceived stress and resilience were not significant, according to the researchers.

During the qualitative interviews, physicians in the TM group also reported a reduction or disappearance in burnout, including stress, fatigue and anxiety.

“Their reported experiences included increased productivity, confidence, happiness, control of their actions, mental clarity, and improved relationships, that is, enhanced professional fulfillment,” Loiselle and colleagues wrote.

In the nontreatment group, most physicians reported increased stress and work hours, while all participants cited stressful systematic issues.

Because burnout can lead to depression and depression can lead to further burnout, “finding depression and burnout significantly reduced in this study further corroborates their connections and the effectiveness of the intervention in reducing both,” Loiselle and colleagues wrote.

They concluded that the study results demonstrated TM as an effective intervention for physician burnout and proceeding symptoms, while laying the groundwork for future research on the technique in the physician setting.

“Although this research was conducted before the COVID-19 pandemic, its implications are highly relevant to the challenges physicians are currently facing,” the researchers wrote. “We recommend future research be pursued with the TM technique using larger numbers of subjects in a variety of medical settings."