The dark side of meditation: Mental health risks
MDlinx May 04, 2024
Meditation has long been regarded as a magic formula for mental health. Yet, despite its widespread application and benefits, researchers have noted adverse reactions in a subset of the population.
Stories of “meditation gone wrong” have left some providers wondering if they’ve been advocating for meditation responsibly.
Unfortunately, there isn’t a clear method to determine what type of patient or which circumstances present the greatest risk of adverse events.
Exploring the risks of meditation
Meditation has been around for thousands of years and is generally regarded as safe and beneficial for most people. However, a subset of practitioners experience negative psychological outcomes known as meditation adverse events (MAEs). In a systematic review and meta-analysis of 83 studies, MAEs were observed in 8.3% of meditators, a similar rate seen with psychotherapy.
Farias M, Maraldi E, Wallenkampf KC, et al. Adverse events in meditation practices and meditationābased therapies: a systematic review. Acta Psychiatr Scand. 2020;142(5):374–393.
The review states, “New studies of long-term meditators indicate that challenging, difficult or functionally impairing effects, which include hospitalization and suicidality, have a median duration of 1–3 years, and tentatively estimate, based on an average 5% rate of adverse events in the general psychotherapy literature, that in the USA alone almost 1 million of individuals may experience negative events associated with meditation.”
A recent NPR article discussed cases of psychosis, terror, hallucinations, and physical pain during meditation retreats.
Muraskin A. A new podcast examines the perils of intense meditation. NPR. March 31, 2024.
These retreats involve long hours of meditation (10 hours a day) and a limited vegan diet of just two meals a day. As a result, experts theorize that extreme circumstances may bring out extreme outcomes for some people—even with those who have had positive meditation experiences prior.
In addition, participants may feel pressured to stay and continue meditating to overcome what’s perceived as “breakthroughs,” only to spiral further down a dark path. Some participants reported lasting trauma from their experience. Others had to be removed in handcuffs.
As meditation maintains widespread support from the medical community, the number of people trying it will likely remain high. However, an advocacy group called the Cheetah House says it’s not the right choice for everyone.
About us. Cheetah House. 2024.
This community of researchers and ex-meditators believes that “claims about meditations are often overhyped.” As a result, they aim to “provide a balanced, realistic, and informed perspective about the risks associated with meditation through the dissemination of research-based information.”
Different forms of meditation
It’s possible that certain types of meditative practice are more likely to put your health at risk. For example, meditative retreats that involve long hours, guided practice, and other potentially harmful practices (such as fasting) may have a stronger impact than a few moments of deep breathing and contemplation before bed.
Meditation may involve physical movement (such as yoga), visualization, or the repetition of mantras. During body-centered meditation, the person tunes into physical sensations, while emotion-centered meditation concentrates on feeling specific emotions. Mindfulness meditation is a popular method that silences thoughts of the past or future, quieting the mind to focus solely on the present moment.
Meditation. Cleveland Clinic. May 22, 2022.
Most common adverse events
The most common adverse events noted in the review included anxiety, depression, and cognitive anomalies. MAEs typically occurred during or immediately after meditation practice.
Adverse psychiatric events were found in 49% of the studies reviewed, including psychotic or delusional symptoms, dissociation or depersonalization, fear, terror, and re-experiencing trauma. Somatic adverse events were reported in 31% of the studies and included stress, physical tension, pain, and gastrointestinal issues.
Neurological and cognitive symptoms were less common, described in 20% of the studies. These ranged from disorganized thinking, amnesia, perceptual hypersensitivity, and memory impairments.
Through the health halo
While meditation’s potential for harm may come as a surprise, it’s not necessarily new information. As far back as 1977, a position statement by the American Psychiatric Association recommended research to evaluate the potential contraindications and dangers of meditation. However, bias toward its clinical benefits have largely shielded meditation from criticism.
American Psychiatric Association. Position statement on meditation. Am J Psychiatry. 1977 Jun;134(6):720.
Unfortunately, a lack of research makes it difficult to predict which patients may be susceptible to adverse effects from meditation. Even studies on mindfulness-based interventions notoriously underreport the downsides of treatment. One systematic review found that fewer than 1 in 5 trials monitored for adverse effects.
Zhang D, Lee EKP, Mak ECW, et al. Mindfulness-based interventions: an overall review. Br Med Bull. 2021;138(1):41–57.
What this means for you
Most people stand to benefit from meditation, especially in its milder forms, such as mindfulness. However, there are some risks to deep meditation, leading to rates of adverse events that parallel those seen with psychotherapy. Understanding this possibility can help facilitate informed consent and validate the experience of patients who find meditation unhelpful or detrimental to their mental well-being.
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