Mindfulness meditation can help, but research shows possible downsides
Mindfulness can calm stress, but research also documents anxiety, pain, derealization, and even psychosis in some settings.
Studies have described adverse events such as anxiety and pain, and more severe events like psychosis, in connection with mindfulness meditation. The most useful question is not whether mindfulness works, but when it needs guardrails.
What the evidence actually says
The NIH-hosted full-text article, “What Are Adverse Events in Mindfulness Meditation?”, anchors this conversation. It treats adverse events in mindfulness meditation as a documented part of the literature, not a fringe claim.
A 2020 systematic review in Acta Psychiatrica Scandinavica, “Adverse Events in Meditation Practices and Meditation-Based Therapies: A Systematic Review,” was written by Miguel Farias, Everton Maraldi, Giancarlo Lucchetti, and Karl Wallenkampf. A 2022 systematic review in the journal Mindfulness, “The Adverse Effects of Meditation-Interventions and Mind–Body Practices: a Systematic Review,” kept the issue in the center of the scientific conversation. Two reviews, two years apart, worked through the same question: how to define adverse effects and how to measure them without flattening very different experiences into one bucket.
A 2016 Guardian piece titled “Is mindfulness making us ill?” showed that the mainstream meditation boom had already outrun the safety conversation. That question still hangs over the practice today, especially as mindfulness gets pushed far beyond clinic settings and into apps, schools, and workplaces.
Where the risk is highest
The most important caution flag is intensity. The literature and the reviews point repeatedly to long retreats, highly immersive training, and advanced practice as situations where adverse experiences are more likely to show up or become more destabilizing. A short guided session is not the same thing as days of silent practice, and it is a mistake to treat all mindfulness as one interchangeable product.
Vulnerability matters too. People with significant psychiatric vulnerability need more caution, not less. A Harvard Medical School and Massachusetts General Hospital Meditation Research Program paper on “Meditation-related psychological adverse effects, challenging, unpleasant, and negative experiences: Toward the safe dissemination and practice of advanced meditation” focuses on the safe dissemination and practice of advanced meditation. Advanced meditation should be disseminated carefully, not sold as one-size-fits-all self-improvement.
Work led by Willoughby Britton, an associate professor of psychiatry and human behavior at Brown, emphasized the importance of defining and measuring the adverse effects of mindfulness. Mindfulness-based programs are sometimes offered to schoolkids, employees, and other non-clinical groups. People need to know that “mindfulness” can surface difficult material, not just calm breathing.
What adverse effects can look like
Meditation-related difficulties can start in ways people dismiss as normal adjustment. A hard session can bring up affective distress, anxiety, or a sharp wave of pain. Some people also report distorted senses of self, depersonalization, or derealization, which can feel like being detached from your own mind or body.
- hallucinations or delusional thinking
- persistent paranoia
- a continuing sense of unreality outside practice
- sleep disruption that does not settle
- loss of functioning in work, school, or relationships
The more serious warning signs are harder to ignore:
Those are not the same as a briefly uncomfortable meditation or a tearful session that passes. They are the kind of symptoms that mean the practice has crossed from challenge into something that deserves attention.
What to do when practice starts to go sideways
The practical response is not to grit your teeth and “push through” just because mindfulness is supposed to be good for you. If practice starts producing panic, serious insomnia, paranoia, or derealization, the first move is to pause and reduce intensity. If you are in a retreat or an advanced course, step back from the structure that is amplifying the problem rather than trying to out-mediate it.
In milder cases, a qualified teacher can help you modify practice so it fits your nervous system instead of overwhelming it. In more serious cases, especially when symptoms persist outside formal practice, a mental health professional is the right next stop. Ordinary discomfort may fade when you shorten the session or change the format, but persistent panic, unreality, or loss of functioning should not be treated as a badge of progress.
Why the numbers are still messy
One reason the field keeps circling this topic is that the prevalence estimates swing a lot from study to study. Researchers have not standardized the measurement of adverse effects, and different studies count different things. Some count only severe events, while others include any unpleasant experience that follows practice, so a low rate in one trial and a much higher rate in a survey can both reflect the same basic reality from different angles.
That measurement problem sits behind the Brown work on defining adverse effects and the 2022 Mindfulness review.
This article was produced by Prism’s automated news system from verified source data, official records, and press releases, then run through automated quality and moderation checks before publishing. The system is built and supervised by the people who set the standards it runs under. Read our full AI policy.
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