Mindfulness helps with anxiety on average, and the evidence is moderate rather than overwhelming. A review of 39 studies found that mindfulness-based therapy moderately improved anxiety from before to after treatment, and in one trial of 276 adults with anxiety disorders an eight-week mindfulness course was not meaningfully worse than the antidepressant escitalopram. [hofmann-2010-mindfulness-therapy] [hoge-2023-mbsr-escitalopram] This guide covers what the research found, three short mindfulness exercises for anxiety, how mindfulness sits beside other treatment, and who should take care. Our overview of anxiety covers the condition itself.
Does mindfulness help with anxiety?
On average, yes, with moderate effects, and how big the effect looks depends on how it was measured. A review of 39 studies covering 1,140 people found that anxiety fell by a moderate amount from before to after mindfulness-based therapy (an effect size of 0.63), and by more, 0.97, in people who had anxiety or mood disorders. [hofmann-2010-mindfulness-therapy] The authors reported that the effects held at follow-up and did not depend on how many sessions people had. [hofmann-2010-mindfulness-therapy]
Those figures measure change over time, so they cannot separate the therapy from the passage of time, expectation or other help people were getting. A review that included only trials with active comparison groups, 47 trials with 3,515 people, found a smaller effect for anxiety: 0.38 at eight weeks and 0.22 at three to six months, which the authors rated as moderate evidence. [goyal-2014-meditation-programs] That review also found no evidence that meditation programmes were better than active treatments such as drugs, exercise or other behavioural therapies. [goyal-2014-meditation-programs]
| Source | What it looked at | What it found for anxiety | What limits it |
|---|---|---|---|
| Hofmann and colleagues (2010) | 39 studies, 1,140 people given mindfulness-based therapy | Anxiety fell by 0.63 overall and 0.97 in people with anxiety or mood disorders | Before-and-after change, so it cannot rule out time or expectation |
| Goyal and colleagues (2014) | 47 trials, 3,515 people, mindfulness programmes against active comparison groups | Moderate evidence: 0.38 at eight weeks, 0.22 at three to six months | Small to moderate effects that were weaker by three to six months |
| Hoge and colleagues (2023) | One trial, 276 adults with anxiety disorders, mindfulness course against escitalopram | Severity improved by 1.35 points with mindfulness and 1.43 with escitalopram | One trial, no placebo group, participants knew their treatment |
None of these shows mindfulness beating other treatments, and one shows it holding its own against a widely used antidepressant. That is a useful result without being a dramatic one.
How does mindfulness compare with medication for anxiety?
In one trial it was not meaningfully worse than escitalopram over eight weeks. The trial randomised 276 adults with generalised anxiety disorder, social anxiety disorder or panic disorder to eight weeks of mindfulness-based stress reduction or to escitalopram. Clinician-rated severity on a seven-point scale improved by 1.35 points with mindfulness and 1.43 with escitalopram, which met the pre-set standard for mindfulness not being worse. [hoge-2023-mbsr-escitalopram] Study-related side effects were reported by 21 people in the mindfulness group and 110 in the escitalopram group. [hoge-2023-mbsr-escitalopram]
Read that with its limits in view. It is one trial, it had no placebo group, and participants knew which treatment they were getting. Our guide to mindfulness-based stress reduction covers the course and the trial in more detail. If you take medication, do not stop or change it without speaking to the person who prescribes it.
How long does mindfulness take to help with anxiety?
The trials measured results after a structured course of about eight weeks, not after a single session. In the largest controlled review the benefit for anxiety was 0.38 at eight weeks and had shrunk to 0.22 by three to six months. [goyal-2014-meditation-programs] So the evidence supports regular practice over weeks, and it does not support expecting a single session to settle a bad day.
What are three mindfulness exercises for anxiety?
Three short ones are anchoring on the breath, naming what is here and scanning the body. Start with whichever feels least demanding and keep each one short. These are brief versions of practices taught in the eight-week courses. The trials above tested the courses and not these exercises, so treat them as a way to find out whether the skill suits you.
- Anchor on the breath (three to five minutes). Sit comfortably and rest your attention on the sensation of breathing, wherever you notice it most. When your mind drifts to a worry, silently say “thinking” and come back to the breath. The coming back is the practice.
- Name what is here (two minutes). Silently label what you notice in plain words, such as “worry”, “tight chest” or “racing heart”, and let it be there without trying to fix it. Our guide to emotional suppression covers why letting a feeling be there is different from hiding it.
- Scan the body (five minutes). Move your attention slowly from your feet to the top of your head, noticing sensations without trying to change them or label them as good or bad.
If turning towards the feeling is too much, our guide to grounding techniques does close to the opposite: it moves your attention to neutral detail outside you.
Three minutes on the breath
Sit comfortably and rest your attention on the sensation of breathing, wherever you feel it most. When your mind wanders to a worry, silently say thinking and come back to the breath.
3:00
Coming back is the practice, so a wandering mind is not a failed session. If breathing makes you more anxious, feel your feet on the floor or listen to the sounds around you, or stop.
Done. Notice how you feel, and whether the worry has changed shape.
Can mindfulness make anxiety worse?
For some people it can. A systematic review of 83 studies covering 6,703 participants found adverse events in 8.3% overall, and reported that they can occur in people with no history of mental health problems. [farias-2020-adverse] Sitting with your attention turned inward can stir up distress, which is a reason to keep early sessions short.
If a practice makes you more anxious, stop and do something grounding. Our guide to when meditation makes things worse covers why it happens and how to practise more safely, and a doctor or therapist can help you choose a different approach or a taught course.
How does mindfulness fit with other anxiety treatment?
As one option among several. Mindfulness-based programmes sit beside cognitive behavioural therapy, exposure-based therapy and medication, and the trials above did not show mindfulness beating any of them. A doctor can help you weigh the options against your symptoms and preferences. Our guide to therapy for anxiety covers what the different therapies involve, and our guide to breathing exercises for anxiety covers what has the best trial evidence for the moment itself. Our overview of mindfulness covers the wider field.
When to seek help
Speak to a doctor if anxiety is hard to control, has lasted most days for several weeks, or is affecting your work, sleep or relationships. A doctor can help you weigh mindfulness against therapy and medication. Our anxiety self-assessment is a screener and not a diagnosis, and it can help you decide whether to have that conversation.
If you feel unable to keep yourself safe, contact your local emergency services or a crisis helpline.
How MyFreud can help
Whether a daily practice is changing how your weeks feel is hard to judge from memory. Daily mood tracking in MyFreud shows the pattern across weeks, so you can compare the weeks you practised with the weeks you did not. It does not replace a course, and it does not replace speaking to a doctor.
Download MyFreud and start today: App Store or Google Play.