For many of us, dealing with depression can feel like a very long, very lonely road, with storm clouds constantly hovering nearby. Depression is the most common mental illness and is also, sadly, very persistent – 80% of people who suffer a major depressive episode will relapse at some time. The efficacy of drugs can reduce over time and for some of us not work at all. However, recent research has shown that mindfulness-based cognitive therapy (MBCT) can halt the chances of a relapse by changing thought patterns – and with the added benefit of no side-effects.
How mindfulness-based cognitive therapy can help sufferers of depression
A recent study (the Lancet 2015) has proved that MBCT is as effective as anti-depressant drugs at preventing a recurrence of depression and the UK National Institute of Clinical Excellence (N.I.C.E) has recently endorsed MBCT as an effective treatment for prevention of relapse. A study has also shown that there was a higher impact (than on overall participants), on those depressives with severe childhood abusive histories and who are therefore at higher risk of relapse. MBCT may also be of most assistance to those patients with a higher number of previous episodes or who have residual depression and who are therefore more vulnerable to relapse.
Those patients suffering depression from an earlier age may benefit more from MBCT due to them being more motivated and more willing to participate in the treatment. They will have been depressed longer and already tried anti-depressants and possibly other types of treatment and may therefore be more prepared to meditate everyday, use mindfulness exercises and engage fully to maximise their recovery.
MBCT also benefits women with a history of depression who want to avoid medication during pregnancy, with mindfulness practise producing a considerable reduction in depression symptoms and relapse. The women who were studied in the research were keen to learn and enjoyed the mindfulness techniques, which would have increased it’s success.
Those of us at risk of depression have to deal with a multitude of negative and distorted thoughts, feelings and beliefs about ourselves and this can often set off a relapse. Other ‘draining’ symptoms are reduced concentration and forgetfulness – all of which can have a negative impact on our lives and interfere with our work or schooling. MBCT can help us to recognise how we’re feeling, accept those thoughts and react in a more positive manner, with compassion and calmness.
Simply put, mindfulness is being aware of all our experiences in the ‘present’ moment. As explained on our page Mindfulness and Mindfulness Exercises…how it can enrich our lives, mindfulness is about paying attention to our thoughts and emotions without judging or becoming wrapped up in them and realising that they’re not accurate reflections of reality. When we are practising a mindfulness exercise and our mind wanders, we can just take note and then gently return to the exercise. MBCT teaches patients to dissociate and liberate themselves from the deep dysfunctional thoughts that are prevalent with depression.
MBCT can include mindfulness exercises such as yoga and body awareness, where we pay full attention to what we are doing, moment by moment and besides being shown to match the effect of medication, it has been proven to have moderate effects on anxiety and pain as well. MBCT can also include elements of cognitive-behavioural therapy (CBT) for those people with prior histories of depression.
Mindfulness practice can help in these ways:
- It helps us understand what depression is
- It helps us to learn what makes us vulnerable to downward mood spirals and why we struggle to come up from the bottom of the spiral
- It helps us recognise the connection between the downward spirals and our feelings that we are ‘not good enough’; the ways we put pressure on ourselves by overworking; and the ways we disconnect with what makes life worth living.
Mindfulness helps to reduce downward mood spirals by:
- Helping us to recognise more clearly the patterns of the mind, to enable us to be aware of when our mood is starting to drop, allowing us to ‘cut if off’ earlier. When we are vulnerable to depression we can ‘lose touch’ with what is happening around us and mindfulness helps us to become more aware.
- ‘Losing touch’ can mean a wall is erected between ourself and the little things in life which can give us pleasure. This can become extreme during clinical depression, but we all know how it feels when we are overloaded with work etc, when we fail to notice the little pleasures all around us. we begin to worry more about the future and brood about the past. Mindfulness helps to bring us back ‘in touch’ with the ‘present’ moment and the pure experience of life itself.
- When we begin to feel low, we can believe our emotions are a problem to be solved and try to use our critical thinking strategies. When this doesn’t work, we increase our efforts and end up over-thinking, brooding and living in our head. Instead, mindfulness helps us shift gear into an alternative way of thinking – from critical thoughts likely to enable the downward mood spiral – to a different method of thinking where we experience the world directly and non-judgmentally.
- Once we have suffered depression, we understandably worry about it returning and at the first sign, will try to pretend the symptoms aren’t there and ignore any unwanted thoughts – this often doesn’t work! Instead, mindfulness encourages us to experience our emotions and our ability to be open to even painful emotions. It gives us the strength to allow difficult moods, thoughts and emotions to come and go, without fighting them. We can understand that we can be aware of distressing thoughts and feelings and see them in a different light that brings with it a sense of warmth and compassion to the suffering you are feeling.
It is thought that as mindfulness helps to improve our self-compassion, it can therefore reduce our avoidance of experiences – whilst focusing on our breath, we are not agonising over our perceived worries and instead merely accepting our thoughts as just thoughts. Depression causes us to have negative thoughts about our experiences, ourselves and the future, but mindfulness can help us to be more aware of those destructive thoughts and allow us to detach from them and simply view them as merely thoughts passing through our minds. We can then learn to control our emotions by recognising we are being self-critical and blaming ourselves for feeling low again or worrying about a relapse and instead practise self-compassion. MBCT helps to control how a depressive’s mind wanders and overfills with worries, by teaching us to live in the ‘present’ rather than brooding about the past, or suffering angst about the future.
The group therapy aspect of MBCT can also help patients overcome their feelings of shame and guilt that depression brings, by helping them to understand that they are not alone and that other’s minds produce negative thoughts too, but they are just thoughts – not reality. It was thought that patients with active depression may struggle to concentrate, but it was found that they were able to practise mindfulness very well and embrace an alternative treatment to more medication, which gives them a stronger sense of their own ability to control the illness.
3 ways mindfulness can help reduce depression
It has been demonstrated how MBCT helps us to relate mindfully to ourself and others and therefore enhances relationships. Less stress about relationships then helps prevent future relapses into depression. The three main ways mindfulness helps are:
- Learning to pause, identify and respond – MBCT allows us to be more aware of the ‘present’ moment, which gives us time to pause before automatically reacting to others and instead of becoming distressed about rejection or criticism, we can step back and identify our own reactions, which allows us to become more attuned to others’ needs and emotions. This awareness then allows us to choose how to respond, without being caught up in negative emotion.
- It’s ok to say ‘no’ – mindfulness can help us to become more assertive when we need to say ‘no’ to reduce our load of responsibility, by recognising our own needs as well as others’. Mindful awareness helps us to approach uncomfortable experiences, which we would previously have avoided and this in turn, increases our self-confidence and assertiveness.
- Being present with others – this allows us to bring more attention to our relationships and to appreciate our time with others. It helps us to release memories of difficult times, allowing us to relate to others in new ways. Mindfulness helps us to recognise our communication problems, which improves our ability to empathise with another’s perspective and therefore focus more constructively on potential solutions in disagreements. It can give us more energy, less overcome with negative emotion and allows us to to better cope with and support others. When we have the mental energy and emotional stamina to spend more time with our loved ones it helps us to grow together. The benefits of MBCT can spread through our whole life – due to our increased confidence we can become more involved with an increased amount of social activity.
How mindfulness, meditation and exercise can help depression
We can practise Mindfulness in any everyday activity – even when showering, getting dressed or eating – by focusing on our physical sensations of sight, taste, touch and smell and being in the ‘present’, rather than the past or future. If we are eating mindfully, we should slow our pace, paying attention to the taste, texture and smell of our food and reduce our distractions by switching off the TV or phone etc.
However, recent research has shown that when we combine mindfulness meditation and aerobic exercise, e.g running, it can help reduce depression and be an important part of healing. The research suggests that combining the two activities gives a vast improvement in depressive symptoms, along with increased synchronised brain activity. Depressives have reported a 40% reduction in their symptoms, with a decrease in ruminative thoughts and anxiety and an overall improvement in motivation. It is thought that combining meditation and running may strengthen neural mechanisms in the brain. Learning how to meditate encourages new neurons to mature in the brain and whilst the exercise will increase the number of new brain cells, the meditation may help to keep more of those neurons alive and maturing.
‘The journey of a thousand miles begins with one step’ Lao Tsu
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