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.

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.^[1]

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.^[2] 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.

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.^[3] 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

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.^[4]

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.

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.^[5]

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.^[6]

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.

References

1. Farias M, Maraldi E, Wallenkampf KC, et al. Adverse events in meditation practices and meditation‐based therapies: a systematic review. Acta Psychiatr Scand. 2020;142(5):374–393.

2. Muraskin A. A new podcast examines the perils of intense meditation. NPR. March 31, 2024.

3. About us. Cheetah House. 2024.

4. Meditation. Cleveland Clinic. May 22, 2022.

5. American Psychiatric Association. Position statement on meditation. Am J Psychiatry. 1977 Jun;134(6):720.

6. Zhang D, Lee EKP, Mak ECW, et al. Mindfulness-based interventions: an overall review. Br Med Bull. 2021;138(1):41–57.