Mindfulness Isn’t a Depression Cure-All

justraisethebar.comA new study from the University of Oxford finds that mindfulness-based cognitive therapy (MBCT) is just as effective as antidepressants for preventing a relapse of depression. In MBCT, a person learns to pay closer attention to the present moment and to let go of the negative thoughts and ruminations that can trigger depression. They also explore a greater awareness of their own body, identifying stress and signs of depression before a crisis hits.

The study is wonderful news because the relapse rate for major depression disorder is as high as 50 percent for persons who have experienced one episode and as high as 80 percent for people who have experienced two episodes of depression. As my psychiatrist said in our last session, it usually takes less medicine to keep someone well than to get someone well. So that means people can wean off antidepressants with a kind of security net under them, without the high risk of relapse.

However, I’m going to risk the backlash from readers and go against popular opinion when I say that I don’t think mindfulness is a cure-all for depression. It has gotten so much buzz lately that I fear that some severely depressed people out there may make the same mistake I did.

Last year this time, I was immersed in an eight-week intensive Mindful-Based Stress Reduction (MBSR) program at Anne Arundel Community Hospital. The course was approved by and modeled from Jon Kabat Zinn’s incredibly successful program at the University of Massachusetts. I was familiar with Zinn’s writings and had read about the many miracles that mindfulness had brought to his patients, from helping with diabetes and arthritis to heart disease and chronic pain. People with insomnia were sleeping through the night, and diabetics were improving their blood sugar.

I salivated over his pages.

I wanted a miracle, too.

I had been unable to break free of chronic “death thoughts” (“I wish I were dead”) for over five years, and was growing disillusioned with traditional psychiatry, as I had tried countless medication combinations that didn’t seem to do much beyond gift me with lovely side effects, and had been in therapy off and on for 20 years. The only thing that did help was aerobic exercise, so I was swimming more than 300 laps some days to escape the thoughts.

There were three people in our small group of 15 that were clinically depressed at the time, or at least were willing to talk about it. During the sixth class, when the instructor was talking about how to let your thoughts be, I became a little agitated and raised my hand. “Are there ever times when your thought process is so distorted that mindfulness and meditation can’t help you?” I asked.

“You can always shift to another object of attention, like from your breath to sound,” she replied.

“No, I mean, like sometimes if you simply get too frustrated trying to meditate, isn’t better to go watch a movie or do something that will distract you?” I was thinking of the introduction to The Mindful Way through Depression, when authors Jon Kabat-Zinn, Mark Williams, John Teasdale, and Zindel Segal write, “It may be wise to not undertake the entire program while in the midst of an episode of clinical depression. Current evidence suggests that it may be prudent to wait until you have gotten the necessary help in climbing out of the depths and are able to approach this new work of working with your thoughts and feelings, with your mind and spirit unburdened by the crushing weight of acute depression.”

I finally quoted Zinn, the Dalai Lama of the MBSR world, to get my point across, and then she agreed with him. But I was relieved when one of my other classmates who had experienced the same kind of debilitating depression I had whispered to me, “I don’t think she has ever been depressed like we have.”

He confirmed what I was thinking during that moment and what has been my experience: mindfulness is better at keeping a person from getting depressed than from pulling a person out of depression.

I say this because I gave the program everything I had. I meditated everyday for 45 minutes for more than eight weeks, read everything I was supposed to for the class, went to a weekly three-hour class, and participated in a retreat. But, upon graduating from the program, I drove home still fighting those damn death thoughts.

I felt like a complete mindfulness and MBSR failure.

What went wrong?

In hindsight, I wish there was more than one paragraph in Zinn’s book about when mindfulness isn’t the solution, about when it’s better to swim laps or ride your bike into town or call a friend you haven’t talked to in awhile. I still would have taken the course—and I do feel like I benefitted immensely from it—but I would have been more forgiving of myself that it didn’t “work” like everyone else’s magic.

Today I am more aware of my stress reactions and am proactive about reducing my stress before I start wilting. I can identify the thinking patterns that lead to depression, like the inner critic and jumping to the future. Especially beneficial is locating tension in a certain region of my body, and trying to relax it. All of this I learned from the class. And I still meditate—actually it has morphed into prayer, which is a more natural form of meditation for me, and more beneficial (for me).

Mindfulness and meditation may very well keep me from relapsing from depression, now that I am finally without the death thoughts.

I hope so anyway.

But I don’t attach to it the magical properties that I did before, and I think we need to be careful in our optimism.

There are many, many tools to help those of us who are at risk for depression relapse.

Mindfulness is one.

Join “Practicing Mindfulness” on Project Beyond Blue, the new depression community.

Published originally on Sanity Break.

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15 thoughts on “Mindfulness Isn’t a Depression Cure-All

  1. I have major depression as well as anxiety issues. Like you, I’ve found mindfulness is great for me when I’m in a period where I’m feeling ok, but if I’m depressed it doesn’t work. I do find it very useful for when I’m feeling anxious. I’ve gotten other friends interested in mindfulness meditation, but I never try and sell it to them as a cure-all, but rather as one way that can help them, and that if they’re severely depressed or anxious then they should seek professional assistance from a doctor (and of course letting them know they aren’t alone and have a friend).

  2. Thanks for being so brave and telling us the truth of your experience.

    I pray a lot too – throughout the day. It is Very helpful to take things to the Lord.

    1. Yes, Prayer on a daily basis does help. I suffer from anxiety. My husband suffers from bipolar depression. At any given time his mood can change. He is on Celexa and limectal. My Dr tried me on Lexapro and celexa for my anxiety. I could not tolerate either of the meds. I constantly walk on egg shells.

  3. I wish something would help me out of this deep, dark, depression I am in. I feel helpless and hopeless. I try doing things to take my mind off of the sadness, but nothing works. I do pray a lot, I feel guilty that nothing is helping. Does anyone have any suggestions? I am desperate right now to feel better. This episode has been a rough 14 months and counting. If anyone has had relief from something, could you please help me? I am a 40 yr old female and don’t remember the last time I have not had depression, although this past 14 months have been almost unbearable. If it were not for my husband and 2 little boys, I dont know where I would be. Thank you for any help you can give.

  4. I appreciate your thoughts, Therese, as usual. I’m a mental health professional with severe recurrent depressions. About 4 years ago I started using another promising depression treatment, the Cranial Electronic Stimulation, which has gotten some good press lately. I got the device, used it every day, and slowly weaned of my multiple antidepressants, under the supervision of my psychiatrist. I felt great for several months! No sexual side effects! I lost weight! Until the winter came along when I crashed into the worst depressive episode that I have ever endured, which lasted for 6 months. During that time, I got The Mindful Way Through Depression, and followed the program carefully. It did not help my depression, and it was very difficult to dedirect my ruminative thoughts, I felt like a failure. Then when I finally came out of the depression, I went into a hypomanic episode, and have been trying to keep the balance ever sense. So, I agree that mindfulness and the CES device does help with relapse prevention and I use both of them, and exercise, etc., but there is no magic bullet for acute depression.

    Sandy

    1. Thanks, Sandy. You must be such a wonderful mental health professional! I am so glad knowing you are there to help people given your struggle yourself.

  5. Thank you for your beautiful candor, Therese. It is always inspiring.

    Your last sentence is so true. Mindfulness is just one tool in the toolbox we can use to try to manage. Not a cure all for sure. To me the danger is that with all the mindfulness success hype people who are struggling with some heavy duty mood disorders may start to feel like failures because they are not able to “fix” themselves with mindfulness. They may feel that it is because they have done something wrong. And that is the last thing we need in a world where everyone wants to tell us that we would get better if we just did more yoga or ate less sugar or got a dog or stood on one foot for an hour (joke nobody told me to do that) etc etc on and on. But seriously our struggles are not understood or appreciated and we now don’t need to be told that we wouldn’t get depressed if we were more mindful. As if we want to be depressed.

    Mindfulness is wonderful and extremely useful but as you said it is not a cure all and should not be seen as a way to put down people who still need medication.

  6. For mindfulness, it is important that the instructions come from someone who has benefited from these practices. Although the study in this article had used ‘assessment criteria’ to evaluate teachers, I think this process could still be subject to bias (considering the ‘competency’ of the person rating the teacher, etc.).
    One thing I have found that works for depression is not to get ‘depressed about being depressed,’ but let it come and let it stay the amount of time it needs to stay – then it goes away eventually. Also, if you are not mindful, you may not even notice happy periods you experience in between (when there is no depression). It is also helpful to note the triggers that bring about a depression episode.

  7. This is just one of the reasons I like your blog so well. You are so real and approach this damned disease with such frankness. It is so frustrating when I read or hear the checklist(s) of “what works.” Yes, sometimes they do. Deep breathing and meditation can often bringSometimes things like mindfulness or meditation simply serve to aggravate the little beasty roaming around my brain, and I have to physically get up and leave the room to find a distraction. Sometimes I need to absolutely NOT be in the moment, and want nothing more than to have someone talk to me about something…anything, and then I’m sorry because that isn’t working and I abruptly need to find a new distraction.

    Thank you for the work you do. It helps people like me know I’m not alone.

    1. Thank you so much, Liz. I appreciate that. Yeah, mindfulness had me hating myself for a long time. Now, when I’m NOT depressed, it is much more useful 🙂

    2. I have tried every approach I was told to do and read every self help book I could find and am on medication so far nothing has helped. I have short periods when I can function more but that lasts approximately three weeks then I am completely depressed again. Mindfulness definitely did not affect this cycle.

      1. Susan, I’m so sorry for your frustration. I know that feeling. You might try to join ProjectBeyondBlue.com and ask others what they are doing, because we are a group of people with treatment-resistant depression. Many of the members swap ideas like diet approaches and other things that have helped that you don’t necessarily hear about from your doctor. I don’t want to claim that I have the answer. I am on the journey just as you are, but eliminating sugar made a huge difference for me. You might try that if you haven’t already. It’s hard, but I feel so much better without the sugar that I don’t miss it anymore. At any rate, know that you are in my prayers. Therese

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