CLOSE YOUR EYES. PAY ATTENTION TO YOUR BODY. BREATHE. The practice of mindfulness, a trained state of being calm and aware, has increasingly found favor as a medical treatment, with study after study showing potential benefits. Mindfulness can reduce the risk of relapse in people with depression, help manage chronic pain and improve some measures of heart health. The question for researchers now is exactly how that therapeutic boost takes place.

Some of the benefit clearly comes from reducing stress, which over many years can lead to chronic illness, says neuroscientist Richard Davidson, founder and director of the Center for Healthy Minds at the University of Wisconsin-Madison. “If we’re able to change our relationship to the stressors of everyday life, we can address these issues preventively,” Davidson says.

Yet many of the finer links between stress and illness remain elusive. Davidson is investigating, for instance, why people who practice mindfulness tend to have fewer markers of inflammation. In one study, people who took an eight-week mindfulness course and meditated more than 4.5 hours per week produced lower levels of TNF-alpha and IL-8—both signaling molecules that can create a systemwide immune response—than a control group when faced with psychological stress. Other molecular signals may also be affected, and Davidson’s group is looking at how mindfulness might correlate with known markers of inflammation in the brain that have been linked to dementia.

The Benson-Henry Institute for Mind Body Medicine (BHI) at Massachusetts General Hospital has developed its own eight-week mind-body program, which incorporates meditation, mindfulness, yoga and elements of cognitive behavioral and positive psychology as well as other techniques. Those who have gone through the program showed changes in the NF-κB pathway—an important chain of protein responses that triggers inflammation and immune function. Those benefits appeared both in meditators who had years of experience as well as in those who had just completed the program. 

Psychiatrist John W. Denninger, director of research at BHI, has been digging into those NF-κB pathway changes. Practicing mindfulness and other meditation techniques appears to result in improved insulin function, helping the body process sugars more effectively, while also boosting the resiliency and function of mitochondria, the engines in cells that produce energy. Both of those functions are thought to go awry in chronic conditions such as hypertension, obesity and type 2 diabetes.

More studies are needed to show the role mindfulness might play in protecting against those and other kinds of chronic problems, Denninger says, but the molecular findings so far imply that research on those conditions might be fruitful. Already, his group recently found that a mind-body relaxation program can reduce inflammation and pain in people with irritable bowel syndrome or inflammatory bowel disease, and the NF-κB pathway seems to play a role.

While most of the action takes place in the immune system, those immune processes are set in motion by what happens in the brain. In one recent studyHedy Kober, director of the Clinical and Affective Neuroscience Laboratory at Yale University, gave participants 30 minutes of training on how to practice mindfulness. The trainees were then shown a series of disturbing images. Functional magnetic resonance imaging showed that activity in the amygdala—a section of the brain responsible for fear and other strong emotions—decreased in patients when they practiced their new mindfulness skills. (Separate research has linked high amygdalar activity to cardiovascular events, and may explain one way that stress increases the risk of heart problems.)

Kober’s researchers also looked at brain activity when uncomfortably hot water was dribbled on the subjects’ arms. In participants who were practicing mindfulness, brain regions known to be recruited as part of the pain response—the secondary somatosensory regions, the dorsal anterior cingulate cortex, the thalamus and the insula—were less active than they were in subjects who weren’t meditating. It was as if those practicing mindfulness were experiencing a much lower grade of pain, Kober says.

Her group has also been looking at the long-term effects of meditation. Extended exposure to the practice appears to create deep-seated changes in brain organization, affecting areas that regulate emotion and attention. “Our findings suggest that the meditator’s baseline way of experiencing the universe becomes quieter and calmer and not quite as involved and distracted as other people’s,” Kober says.

Such skills might be particularly useful during a pandemic, helping mitigate the damaging impact of economic and family stressors on the body. There may be yet another reason to look to mindfulness research now—namely, that a frazzled mind may undermine the body’s response to a viral infection. “The evidence suggests that mindfulness and meditation have the potential to augment certain aspects of the immune system,” Denninger says.

In one of Davidson’s earlier studies, participants were given the flu vaccine. Those who underwent the meditation training program had a greater immune response to that shot, developing more protective antibodies from the vaccine than the control group. That research might be worth revisiting as the world prepares for the first COVID-19 vaccines to appear.

But even if mindfulness does not become a front-line weapon against COVID-19, more widespread adoption of the practice could show unforeseen benefits down the road, as inflammation and stress are implicated in more and more diseases. “The promise of mindfulness really lies upstream, in preventing certain diseases from occurring,” Davidson says. “And as an added bonus, mindfulness enables us to cope more effectively with the challenges of everyday life.”