Beyond serenity: Adverse effects of meditation and mindfulness in clinical practice

Despite the growing popularity of mindfulness, mindfulness-based programs (MBPs), and meditation, potential harms have largely been overlooked. Recent studies reveal that 25-87 % of those who engage in meditation report adverse effects (AEs), with 3-37 % experiencing functional impairment (e.g., inability to work). It remains unclear to what extent AEs reflect transitory discomfort vs. lasting harm. Common AEs include anxiety, depression, and traumatic re-experiencing. Factors such as retreat attendance and pre-existing mental health conditions may increase the risk of AEs, though causality remains unclear. The review emphasises the need for thorough screening, informed consent, and ongoing monitoring in clinical practice. Recommendations include setting clear expectations, offering psychoeducational support, and adapting interventions when necessary and where appropriate. By addressing these concerns, clinicians can better balance the potential benefits with the potential risks, ensuring more responsible implementation of mindfulness and meditation in mental health care and beyond.